From the Research
Relationship Between Edema and Hypovolemia
- Edema can be associated with hypovolemia, as evidenced by studies that show fluid extravasation from the intravascular space to the interstitial space can lead to decreased circulating blood volume 1, 2, 3.
- Capillary leak syndrome, characterized by increased endothelial permeability, can result in hypovolemia and edema formation 1, 2.
- Inflammatory disease states, such as sepsis, can disrupt the balance of fluid exchange between the plasma and interstitial space, leading to hypovolemia, hypoalbuminemia, and peripheral edema 3.
- Experimental studies suggest that mechanisms such as acute lowering of interstitial pressure and nitric oxide-induced inhibition of lymphatic pumping contribute to the combination of hypovolemia, hypoalbuminemia, and edema 3.
Pathophysiology of Fluid Imbalance
- Fluid imbalance can arise due to hypovolemia, normovolemia with maldistribution of fluid, and hypervolemia, with trauma and dehydration being common causes of hypovolemia 4.
- The consequences of hypovolemia include reduction in circulating blood volume, lower venous return, and arterial hypotension, which can lead to myocardial failure and multi-organ failure 4.
- Excessive volume administration can lead to fluid overload and associated impairment of pulmonary function, while increased vascular permeability in certain pathologic conditions can facilitate fluid entry into the lungs 4.
Clinical Implications
- Fluid management is critical in the treatment of capillary leak syndrome, as hypovolemia and hypotension can cause organ injury, while capillary leakage of administered fluid can worsen organ edema 2.
- The treatment of acute cardiogenic pulmonary edema is associated with the return of hypo-oncotic fluid from the interstitial compartment back into the intravascular compartment, expanding plasma volume and reducing colloid osmotic pressure and hemoglobin concentration 5.