Summary
Sumario Shock hipovolemico resumen
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Etiologia, fisiopatologia, diagnóstico, tratamiento.
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SHOCK HIPOVOLÉMICOEl shock se define como una hipoperfusión tisular generalizada en donde existe un
inadecuado aporte de oxígeno a nivel celular para satisfacer las demandas metabólicas.
El shock hipovolémico es aquel que se presenta cuando disminuye el volumen plasmático
por causas hemorrágicas o no hemorrágicas. Este es el tipo de shock más frecuente en los
pacientes quirúrgicos y traumáticos.
Etiología
Traumatismos (intratorácico, intracraneal).
Hemorragia digestiva (varices esofágicas, úlcera péptica).
Postoperatorio.
Diuréticos.
Pérdidas gastrointestinales (diarrea, vómitos).
Ascitis.
Quemaduras.
Desnutrición.
Deshidratación.
Fisiopatología
La pérdida aguda de sangre produce una disminución de la estimulación barorreceptora de
los receptores de estiramiento en las grandes arterias, lo que ocasiona una disminución de la
inhibición de los centros vasoconstrictores en el tallo encefálico y una disminución de los
receptores auriculares de estiramiento. Todos estos efectos favorecen la vasoconstricción y
la resistencia arterial periférica. Además, la hipovolemia induce estimulación simpática, que
conduce a la liberación de epinefrina y norepinefrina, activación de la cascada de renina-
angiotensina y mayor liberación de vasopresina.
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