Edema PDF

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Summary

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Description

Edema Edema is the abnormal accumulation of fluid in certain tissues within the body. The accumulation of fluid may be under the skin - usually in dependent areas such as the legs (peripheral edema, or ankle edema), or it may accumulate in the lungs (pulmonary edema). The location of edema can provide the health care practitioner the first clues in regard to the underlying cause of the fluid accumulation. What Are the Symptoms of Edema? Symptoms will depend on the cause of edema. Peripheral edema Symptoms of peripheral edema include swelling of the affected area(s), which causes the surrounding skin to "tighten." The swelling from peripheral edema is gravity-dependent (it will increase or decrease with changes in body position). The skin over the swollen area appears tight and shiny, and often when pressure is applied to the area with a finger, an indentation appears. This is called pitting edema. Pitting edema is classified based on the depth and duration of the indentation. The following scale is used to rate the severity:    

Grade 1: The pressure applied by the doctor leaves an indentation of 0–2 millimeters (mm) that rebounds immediately. This is the least severe type of pitting edema. Grade 2: The pressure leaves an indentation of 3–4 mm that rebounds in fewer than 15 seconds. Grade 3: The pressure leaves an indentation of 5–6 mm that takes up to 30 seconds to rebound. Grade 4: The pressure leaves an indentation of 8 mm or deeper. It takes more than 20 seconds to rebound.

What Causes Edema? The cause of edema is that tiny blood vessels in the body (capillaries) leak fluid into the surrounding tissues. This excess fluid causes the tissues to swell. The cause of fluid leaking into the surrounding tissues may be the result of several mechanisms, for example: 1. too much force, or pressure inside the blood vessels; 2. a force outside of the blood vessel causes the fluid to be drawn through it; or 3. the wall of the blood vessel is compromised and cannot maintain equilibrium, leading to a fluid loss. Each of these three mechanisms may be associated with a variety of diseases or conditions. Examples include the following. 

Pregnancy: Edema during pregnancy may occur because pregnant women have a greater volume of fluid circulating in the body.

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Medications: Edema may be caused by a variety of medications, for example, steroids, calcium channel blockers, NSAIDs, estrogens, etc.

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Liver disease and/or kidney disease: Both of these organs are vital in maintaining fluid balance in the body, and if severe disease is present in either of these organ systems, edema can develop.

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Venous insufficiency: This is a common condition in which blood does not return to the heart efficiently from the peripheral areas of the body (for example, the ankles, legs, feet, hands), which results in edema. This typically results in edema in both legs since the gravity of the legs cause it more difficult for the blood to return to the heart.

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Heart failure: If the heart is weak and cannot pump blood efficiently, blood will pool in particular areas of the body, which will cause fluid to leak from the blood vessels into the surrounding tissues.

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If the right side of the heart is weak, pressure will build in the peripheral tissues in the body (hands, ankles, feet, legs). This is referred to as peripheral edema.

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If the left side of the heart is weak, pressure will build in the lungs, causing pulmonary edema.

Idiopathic edema: Accumulation of fluid in surrounding tissues with no identifiable cause.

Treatment This involves addressing the underlying cause of the edema. A range of treatments correspond with the range of causes, but common methods include: 

elevating the swollen limbs above the level of the heart

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wearing compression stockings to encourage circulation

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increasing blood protein levels such as albumin

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taking diuretics to flush out excess fluid...