{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T17:31:59Z","timestamp":1793035919339,"version":"4.5.0"},"reference-count":53,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathophysiology"],"abstract":"<jats:p>Patients with preload-dependent conditions are at high risk of hemodynamic instability from both hypovolemia and hypervolemia. In hypovolemic states, the presence of third spacing may be misleading and obscure true intravascular volume status. Therefore, management of critically ill patients should be guided by a thorough understanding of physiology and pathophysiology to appropriately address hemodynamic derangements. Overreliance on rigid protocols and protocol-driven care without adequate clinical judgment may, in some cases, adversely affect patient outcomes. Herein, we present a case of hypovolemia-induced hypotension in the setting of third spacing and concentric left ventricular hypertrophy.<\/jats:p>","DOI":"10.3390\/pathophysiology33020027","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T07:48:12Z","timestamp":1776412092000},"page":"27","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Hypovolemic Shock in the Setting of Third Spacing with Concentric Left Ventricular Hypertrophy: A Physiology-Guided Management of Fluid Resuscitation\u2014Case Report and Literature Review"],"prefix":"10.3390","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4219-3659","authenticated-orcid":false,"given":"Akram M.","family":"Eraky","sequence":"first","affiliation":[{"name":"Emergency Medicine Department, Freeman Health System, 3125 S Waterview Ln, Unit 10, Joplin, MO 64804, USA"},{"name":"Graduate Medical Education, Kansas City University, Kansas City, MO 64106, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasser","family":"Mokhtar","sequence":"additional","affiliation":[{"name":"Pulmonology and Critical Care Medicine Department, Freeman Health System, Joplin, MO 64804, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy","family":"Grabau","sequence":"additional","affiliation":[{"name":"Pulmonology and Critical Care Medicine Department, Freeman Health System, Joplin, MO 64804, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adnan","family":"Khan","sequence":"additional","affiliation":[{"name":"Pulmonology and Critical Care Medicine Department, Freeman Health System, Joplin, MO 64804, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Jarosz","sequence":"additional","affiliation":[{"name":"Graduate Medical Education, Kansas City University, Kansas City, MO 64106, USA"},{"name":"Internal Medicine Department, Freeman Health System, Joplin, MO 64804, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alisha","family":"Wright","sequence":"additional","affiliation":[{"name":"Emergency Medicine Department, Freeman Health System, 3125 S Waterview Ln, Unit 10, Joplin, MO 64804, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Grounds","sequence":"additional","affiliation":[{"name":"Emergency Medicine Department, Freeman Health System, 3125 S Waterview Ln, Unit 10, Joplin, MO 64804, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Emergency Medicine Department, Freeman Health System, 3125 S Waterview Ln, Unit 10, Joplin, MO 64804, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Hahn, R.G. 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