It refers to a state consisting of an acute peripheral circulatory failure.
Hypoperfusion is the condition that features decreased blood flow through organs or tissues. It can become deadly and lead to more severe diseases.
The term means “low perfusion.” The word “perfusion” refers to the action of pumping blood through the body
But in this case, Hypoperfusion implies that the patient suffers from a pathology that causes reduced perfusion of bodily tissues, which leads to inadequate oxygen and nutrients delivery to the organs.
Some people know this condition as “Circulatory Shock.”
More often than not, a Circulatory Shock is a result of inadequate cardiac output.
However, several other factors can steadily or massively decrease the volume of blood pumped by the heart, such as a wide variety of diseases and circumstances.
Some factors that could be related to the inadequate pump function include:
- Inadequate preload
- A lacking contractile strength
- Low heart rate
- Excessive afterload
Another relevant factor in the development of Hypoperfusion or Circulatory Shock is Hypovolemia, which consists of a remarkable decrease in the volume of circulating blood.
In other cases, the cause of the Shock originates in the vascular system mostly due to a low systemic vascular resistance.
Several conditions and particular circumstances can lead patients to develop Hypoperfusion.
One of such conditions is Bradycardia, which refers to an abnormally low heart rate that can result in systemic hypotension, progressive heart failure, and cerebral hypoperfusion.
Coarctation of the Aorta, which is a congenital heart defect, can lead to heart failure, as well as to lower extremity and Renal Hypoperfusion.
Another cause of Circulatory Shock is a clinical syndrome known as Cardiac Tamponade, which consists of an accumulation of blood, fluid, or pus in the pericardial space.
A Cardiac Tamponade can cause an increase in intra-pericardial pressure, restricting cardiac filling and decreasing cardiac output. That leads patients to develop Pulmonary Edema and Hypoperfusion.
Hypertrophic Obstructive Cardiomyopathy (HCM) refers to a cardiovascular genetic disease that features the thickening of a portion of the heart. Hypoperfusion is a common finding in cases of HCM.
The prolonged use of some medications can also cause a Circulatory Shock; such is the case of diuretics and even a calcium-sensitizer like Levosimendan, which has a vasodilatory effect.
In a few cases, degenerative disorders such as the Parkinson’s Disease features different degrees of Hypoperfusion.
The obstruction featured in Pulmonary Thromboembolism is a relatively uncommon cause of Hypoperfusion.
Some people say Diabetes can cause a Circulatory Shock, but medical experts uphold this is merely an unproven theory.
In fact, researchers still don’t know whether Diabetes causes the Cerebral Hypoperfusion or the cases found occur due to other independent factors.
A sedentary lifestyle along with prolonged bed rest and poor dietary habits contribute to a low blood flood to organs and tissues.
In other circumstances, a remarkable loss of fluids due to bleeding or dehydration can also lead to Hypoperfusion.
Hypoperfusion usually features general weakness and lightheadedness, as well as chest pain and palpitations.
When Hypovolemia causes the condition, symptoms may include a constant thirst due to the low flow of fluids.
Since a Shock generates vasoconstriction and loss of circulating red blood cells, another sign is unusual or extreme paleness (Pallor).
In some cases, patients may display hypotension and a sensation of coldness in their skin.
As the brain increases the activity of the sympathetic nervous system, some patients may suffer from an abnormally fast heart rate (Tachycardia).
Due to the inadequate oxygen supply at a tissue level (Hypoxia), and as a response to stress, the brain elevates the respiratory rate, which results in abnormally rapid breathing (Tachypnea).
The combination of Hypoxia and Hypovolemia along with other factors inherent to this condition lead to decreased urinary output.
Vasoconstriction along with Tachycardia cause a loss in intravascular volume, which makes arteries shrink in width and weakens the peripheral pulse.
In other cases, Hypoperfusion also causes Hypotension due to diminished cardiac output.
When it comes to Cerebral Hypoperfusion, this condition causes confusion, restlessness, combativeness, and unconsciousness.
In severe cases, a Circulatory Shock causes critical organ failure and cardiac arrest.
Hepatic Hypoperfusion can also result in Neonatal Jaundice, a condition that makes the skin of a baby and the sclera of the eyes look yellow.
Medical experts often attempt to identify the presence of this condition by measuring or estimating the cardiac output.
They usually rely on predefined profiles composed of combined clinical examination sings to diagnose if a patient’s blood flow is lower than it should be.
Doctors look for signs of compensatory mechanisms, such as Tachycardia and Tachypnea. Many find useful to pay attention to the respiratory rate or seek evidence of Hypotension.
However, none of this provides with a conclusive diagnosis. But recent studies reveal that near-infrared spectroscopy could be a useful noninvasive technique to measure Hypoperfusion.
Several options are available to deal with this condition:
- Supportive Care
- Intravenous Fluid Therapy
- Surgical control of bleeding (in cases of Hemorrhagic Shock)
- Use of inotropic or vasopressor drugs
- Use of Epinephrine
However, given the wide variety of causes for Hypoperfusion, the treatment will largely depend on what is causing the condition.