If hypotension is due to hypovolemia, which hemodynamic pattern would you expect?

If hypotension is due to hypovolemia, which hemodynamic pattern would you expect?

• A. CO ↓, CI ↓, CVP ↓, PAP ↓, PAOP ↓, SVR ↑
• B. CO ↑, CI ↑, CVP ↓, PAP ↓, PAOP ↓, SVR ↓
• C. CO ↓, CI ↓, CVP ↑, PAP ↑, PAOP ↑, SVR ↑
• D. CO ↓, CI ↑, CVP ↓, PAP ↑, PAOP ↓, SVR ↑

Answer: (A)

When hypotension comes from hypovolemia, the circulating blood volume is reduced, so the heart is underfilled. That means preload drops, which leads to a lower stroke volume and thus a lower cardiac output. The body compensates by constricting the arteries to raise the systemic vascular resistance, helping maintain blood pressure despite the low volume. Filling pressures reflect how much blood is returning to the heart and filling the chambers, so with hypovolemia both right and left filling pressures fall: CVP goes down, PAOP (wedge pressure) goes down, and mean PAP tends to fall as well. Cardiac index mirrors the drop in cardiac output when indexed to body surface area. So the overall pattern you’d expect is: CO decreased, CI decreased, CVP decreased, PAP decreased, PAOP decreased, and SVR increased due to compensatory vasoconstriction. This contrasts with patterns seen in other shock states, where you'd see high filling pressures in cardiogenic shock or low SVR in distributive shock.

When hypotension comes from hypovolemia, the circulating blood volume is reduced, so the heart is underfilled. That means preload drops, which leads to a lower stroke volume and thus a lower cardiac output. The body compensates by constricting the arteries to raise the systemic vascular resistance, helping maintain blood pressure despite the low volume. Filling pressures reflect how much blood is returning to the heart and filling the chambers, so with hypovolemia both right and left filling pressures fall: CVP goes down, PAOP (wedge pressure) goes down, and mean PAP tends to fall as well. Cardiac index mirrors the drop in cardiac output when indexed to body surface area. So the overall pattern you’d expect is: CO decreased, CI decreased, CVP decreased, PAP decreased, PAOP decreased, and SVR increased due to compensatory vasoconstriction. This contrasts with patterns seen in other shock states, where you'd see high filling pressures in cardiogenic shock or low SVR in distributive shock.