Choc Hypovolemique

Question 1

Volume sg normal ds corps

Hypotension si perte de cb de sg

Answer 1

65-75 ml/kg 2/3 circu systemique

Hypotension si perte >1/3 volime sang

Question 2

Volume veineux contraint?

Answer 2

Volume sg NON contraint: sang necessaire a pas de collapsus veines

Volume contraint : sang vn supplementaire a la distension veines

Question 3

Etio choc hypoV

Answer 3

1/ hypovolemie absolue
Hemorragie
Perte eau plasmatique : cutané dig, renal, 3 eme sect
Extravasation eau plasmatique : sd nephro, denutrition

2/ hypovolemie relative

Vasodilatation intenseav augmentation volule non contrain

Question 4

Classes de choc hemo

Answer 4

1-perte de 15% sg (750ml), <100bpm, TA normal,
2-perte de 30% (750-1L), >100bpm, TA N,FR>20, agitation
3-perte de 40%(1500-2000ml)!, bpm>120, fr> 30, TA DIMINUEE, CONFU
4- perte>40%,>2 L, tachy, hypotension, polypnee, lethargie

Question 5

Bio choc hemo

Answer 5

Nfs p
Bilan transfu
Bilan coag
Creat uree iono
Lactates
Gds : acidose metabolique : hypoperfu tissu: severe
Nfs p : sous estimation car concentration puis hemodilition dut au relplissage

FOGD <24 h apres templissagesi rien TDM INJ

Question 6

Triade aggravant choc hemorr

Answer 6

Acidose meta
HypoT
Coagulopathie

Question 7

Obj plq, fibrino, hb pad

Answer 7

Transfuser plQ si <50
Transfuser fibrino si <1g (N=2-4). 
Tp>40% sinon PFC
Hb >8 CULOT O URG
NORADRE SI PAD<40