Hemorrhagic shock: A mini review

Abstract

Hemorrhagic shock is a life-threatening condition caused by acute intravascular volume loss, leading to systemic tissue hypoperfusion, cellular hypoxia, and circulatory failure. It remains a leading cause of preventable death after injury worldwide. This review synthesizes current evidence on the pathophysiology, classification, diagnosis, and clinical management of hemorrhagic shock. Pathophysiologically, acute blood loss reduces cardiac preload and output, triggering neurohormonal compensation, anaerobic metabolism, and progression toward the lethal triad of trauma: hypothermia, metabolic acidosis, and coagulopathy. Diagnostic evaluation relies on the Advanced Trauma Life Support (ATLS) classification system, point-of-care ultrasound, and serial biomarker assessment. Contemporary clinical management emphasizes damage control resuscitation (DCR), including early definitive hemostasis, restrictive crystalloid administration, permissive hypotension, balanced transfusion of blood products, and damage control surgery. Prompt recognition and protocol-driven resuscitation significantly improve survival.