C37 Edema

Plasma and interstitial fluid exchange

REDUCTION OF EFFECTIVE ARTERIAL VOLUME

RENAL FACTORS AND THE RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM

ARGININE VASOPRESSIN

ENDOTHELIN-1

NATRIURETIC PEPTIDES

CLINICAL CAUSES OF EDEMA

Primary mechanismClinical examples
Increased capillary hydrostatic pressureHF (LV & cor pulmonale)
Primary renal sodium retention (renal disease & drugs)
Venous obstruction (eg, cirrhosis & venous insufficiency)
Decreased capillary oncotic pressure (hypoalbuminemia)Protein loss (eg, nephrotic syndrome & protein-losing entropathy)
Decreased albumin synthesis (eg, cirrhosis & malnutrition)
Increased capillary permeabilityBurns, trauma & sepsis
Allergic reactions
ARDS
Malignant ascites
Lymphatic obstruction/increased interstitial oncotic pressureMalignant ascites
Hypothyroidism
Lymph node dissection

GENERALIZED EDEMA

LOCALIZED EDEMA

DISTRIBUTION OF EDEMA

APPROACH TO THE PATIENT

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