The principal function of the circulatory system is to supply oxygen and vital metabolic compounds to cells throughout the body, as well as removal of metabolic waste products. Circulatory shock is a life-threatening condition whereby this principal function is compromised. When circulatory shock is caused by a severe loss of blood volume or body water it is called hypovolemic shock, which is the focus of this chapter. Regardless of etiology, the most distinctive manifestations of hypovolemic shock are arterial hypotension and metabolic acidosis. Metabolic acidosis is a consequence of an accumulation of lactic acid resulting from tissue hypoxia and anaerobic metabolism. If the decrease in arterial blood pressure (BP) is severe and protracted, such hypotension will inevitably lead to severe hypoperfusion and organ dysfunction. Rapid and effective restoration of circulatory homeostasis through the use of fluids, pharmacologic agents, and/or blood products is imperative to prevent complications of untreated shock and ultimately death.

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