Hypervolemia - Causes, Symptoms And Treatment

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Hypervolemia - what is it and how to treat it?

Hypervolemia is an increase in the volume of blood available in the vascular system. Depending on the hematocrit, simple, oligocythemic, polycythemic hypervolemia are distinguished. When diagnosing isolated hypervolemia of the pulmonary circulation, we are talking about pulmonary hypertension.

The disease is considered to be outside the normal volume of blood circulating in the human vascular system.

The norm is the volume of circulating blood equal to 1/13 of body weight, or 6-8% of it. Based on this formula, you can calculate the total blood volume in a person. For example, with a weight of 80 kg, it is about 6 liters.

Content:

• Causes and types of hypervolemia
• Symptoms, diagnosis and treatment of hypervolemia
• Hypervolemia of the small circle of blood circulation

Causes and types of hypervolemia

Hypervolemia is not an independent disease, but a complex of symptoms of various pathologies.

The following blood components are distinguished:

• liquid part, or plasma;
• shaped elements, or all blood cells.

Hematocrit is the ratio of the sum of blood cells to the total volume of blood in the vascular system. Its norm is from 36 to 48%, that is, in 100 ml of blood there are 36-48 ml of blood cells, the remaining 52-64 ml is plasma. The classification of the disease depends on the hematocrit index.

Simple hypervolemia

With this type of pathology, the hematocrit indicator remains within normal limits, but the volume of blood circulating in the vascular system increases.

The reasons:

• Transfusion of the amount of blood for which the volume of blood vessels is not designed;
• High physical activity;
• Significant increase in ambient temperature;
• Hypoxia.

In all cases, except for the first, blood replenishes the circulatory system, coming there from its own depots.

Oligocythemic hypervolemia

The index of the hematocrit number falls below the standard values, the blood volume increases due to the increase in plasma volume, and hydremia is formed.

Factors leading to hydremia:

• pregnancy - changes in the composition of the blood contribute to the successful course of metabolic processes between the fetus and the body of a pregnant woman;
• intensive transport of fluid into the vascular system: transfusion of plasma and substitutes, soaking of the fluid component from the surrounding tissues with edema through the walls of blood vessels, drinking plenty of fluids;
• violation of the dehydration process: sodium retention, renal failure, increased secretion of antidiuretic hormone.

Polycythemic hypervolemia

With this type of hypervolemia, the hematocrit number increases due to an increase in the proportion of the cellular component in the vascular system.

The reasons:

• hematological pathologies: tumors of any etiology, genetically determined developmental abnormalities;
• hypoxia caused by prolonged exposure to high altitudes, heart and lung failure.

Symptoms, diagnosis and treatment of hypervolemia

The type of pathology depends on its symptoms and the prescribed treatment tactics. If the disease is caused by reasons to which the body can adapt, and its symptoms are short-lived, the circulatory system will recover on its own.

If the disease is based on acute or chronic dysfunction of organs and systems, therapy is aimed at reducing the volume of circulating blood, at correcting the symptoms of the disease.

Symptoms:

• Increased blood pressure;
• Manifestations of angina pectoris, heart failure;
• Dyspnea;
• Swelling;
• Feeling of heaviness when breathing, increasing its frequency;
• Back pain;
• Headache;
• Increase in body weight;
• Violation of urination;
• Dry skin and mucous membranes;
• Increased fatigue.

Modern medicine does not have in its arsenal of methods for determining the volume of circulating blood. The diagnostic methods available today are applicable only in experimental medicine and have no practical value. To determine the type of pathology and its causes in hematology, the definition of the hematocrit is used.

Disease therapy is carried out in two directions:

• Etiotropic treatment - eliminates the cause of hypervolemia;
• Symptomatic treatment - relieves the manifestations of pathology.

What is the purpose of the etiotropic treatment:

• Surgical treatment of heart defects;
• Therapy of diseases of the endocrine, urinary system;
• Genetically determined diseases of the circulatory system;
• Tumors of any etiology;
• Control of the volume of infusion with intravenous infusion.

Areas of symptomatic treatment:

• Relief of high blood pressure with antihypertensive drugs in combination with diuretics;
• Reducing the load on the heart while using drugs for the treatment of angina;
• Placement of the patient in an oxygenated environment with a comfortable temperature.

Traditional medicine recipes:

• Hirudotherapy (treatment with leeches): reduces blood volume, dilutes it and slightly reduces the number of corpuscles;
• Herbal diuretics: fennel, horsetail, bearberry, dill, viburnum.

It is important that diagnostic and therapeutic measures are carried out under the guidance of an experienced doctor, because a seemingly harmless condition can mask the initial stages of a complex pathology.

Hypervolemia of the small circle of blood circulation

The human circulatory system consists of a large and small circles of blood circulation. The large circle includes the vessels that feed all organs and tissues except for the vessels that feed the broncho-pulmonary system, the small circle contains exclusively the vessels of the lungs.

Distribution of blood in the circulatory system:

• in the veins - 70%;
• in the arteries - 15%;
• in capillaries - 12%;
• inside the heart muscle - 3%.

In the large circle of blood circulation, from 75 to 80% of the total volume of the bloodstream circulate, in the small circle - 20-25%.

Hypervolemia of the pulmonary circulation is based on high pressure in the vessels of the broncho-pulmonary system, therefore it is called pulmonary hypertension.

Causes of small circle hypervolemia

Factors leading to pulmonary hypertension:

• Reflex narrowing of the small vessels of the lungs. Occurs with severe stress, mitral stenosis, embolism.
• Prolonged alveolar hypoxia. It occurs as a result of silicosis, chronic bronchitis, emphysema, obstructive pulmonary disease, anthracnose, bronchiolitis, bronchiectasis.
• Left ventricular failure. It occurs with cardiac arrhythmias, as a result of a heart attack, myocarditis.
• Increased blood density.
• Increased pressure inside the airways. It occurs with a strong cough, an increase in the barometric pressure of the external environment, violations of the mechanical ventilation.
• Narrowing of the vessels that drain blood from the lungs. It occurs with aortic aneurysm, tumors, adhesions, congenital malformation.
• Genetically determined pathology of the enzyme system.
• Increased blood ejection by the right ventricle.
• Narcotic intoxication with psychostimulants.
• Infection with the AIDS virus.
• Portal hypertension. Causes: cirrhosis of the liver, Budd-Chiari syndrome.
• Apnea, or stopping breathing during nighttime sleep with snoring.

In addition to the factors described above, there are also idiopathic (unknown) causes leading to primary pulmonary hypertension.

Signs of pulmonary hypervolemia

The primary stage of the disease can go unnoticed by the patient. When the symptoms of the disease clearly indicate the presence of dangerous changes, most often the process has gone far, and it is already irreversible.

Signs of pathology:

• shortness of breath, turning into suffocation with increasing load;
• asthenia, its symptoms: insomnia, weight loss, decreased performance, instability of the mental state;
• fainting on exertion;
• dizziness;
• severe cough without sputum production, in advanced cases with hemoptysis;
• heart pain;
• progressive cyanosis;
• arrhythmia;
• pain in the projection of the liver.

Diagnostics of the small circle hypervolemia

Diagnosis of the disease is based on its clinical picture, laboratory and instrumental research data:

• Electrocardiogram (ECG) - helps to identify right ventricular hypertrophy, heart attack, cardiac arrhythmias, pulmonary embolism;
• Chest X-ray - helps in the last stages of the disease to identify an increase in the vascular pattern, hypertrophy of the heart muscle;
• Computed tomography with contrast is an extremely informative study of the state of the heart and blood vessels;
• Ultrasound of the heart - helps to diagnose congenital anomalies, hypertrophy of the heart muscle, to clarify the indicators of vascular blood flow;
• Catheterization of the pulmonary trunk in combination with the introduction of the sensor inside it - allows you to measure the pressure in the vascular system of the small circle, diagnose or exclude pathology.

Treatment of pulmonary hypervolemia

The main direction of pathology therapy is the elimination of the cause that caused it, since hypervolemia is not an independent disease. Pulmonary hypervolemia is provoked by pathological processes occurring in various systems of the human body. Primary hypertension is the most difficult to treat, since its cause is unknown and the source of negative symptoms is unknown.

In the treatment of pulmonary hypervolemia, drugs and methods are used that are used in standard treatment regimens for arterial hypertension. With a decrease in the effectiveness of antihypertensive treatment, Euphyllin and oxygen therapy are used.

The author of the article: Volkov Dmitry Sergeevich | c. m. n. surgeon, phlebologist

Education: Moscow State University of Medicine and Dentistry (1996). In 2003 he received a diploma from the Educational and Scientific Medical Center of the Presidential Administration of the Russian Federation.