Diagnostic Criteria for Hypovolemic Shock

Clinical Criteria

The American College of Cardiology recommends that the diagnosis of hypovolemic shock requires the presence of sustained hypotension (systolic blood pressure <90 mm Hg for >30 minutes or mean arterial pressure <60 mm Hg) along with clinical signs of tissue hypoperfusion, including altered mental status, cold extremities, urine output <30 mL/h, and lactate >2 mmol/L 1, 2
The American College of Cardiology suggests that the diagnosis of hypovolemic shock can be established through the combination of hemodynamic and hypoperfusion criteria, including systolic blood pressure <90 mm Hg sustained for >30 minutes 1, 2, 3
The American College of Cardiology recommends that signs of tissue hypoperfusion, such as altered mental status, cold extremities, and decreased urine output, should be present to diagnose hypovolemic shock 1, 2, 4

The American College of Cardiology suggests that invasive hemodynamic monitoring can support the diagnosis of hypovolemic shock, with parameters including cardiac index <2.2 L/min/m² 1, 2, 3
The American College of Cardiology recommends that a pulmonary artery occlusion pressure (PAOP) <15 mm Hg can help distinguish hypovolemic shock from cardiogenic shock 1, 2

The American Heart Association suggests that compensated shock is characterized by the presence of tachycardia, increased systemic vascular resistance, and normal blood pressure 5, 4
The American Heart Association recommends that decompensated shock is characterized by the failure of compensatory mechanisms, resulting in overt hypotension 5, 4

The American College of Cardiology suggests that elements distinguishing hypovolemic shock from other types of shock include venoconstriction, low jugular venous pressure, cold extremities, and weak pulses 4
The American College of Cardiology recommends that a low PAOP can help distinguish hypovolemic shock from cardiogenic shock 1, 2

The American Academy of Pediatrics suggests that hypovolemic shock is the most common form of shock in children, including hemorrhagic shock 5
The American Academy of Pediatrics recommends that criteria for hypoperfusion in pediatric patients include capillary refill time >2 seconds, decreased peripheral pulses, mottled and cold extremities, and urine output <1 mL/kg/h 4, 5