oedema

1. DR. NAGENDRA KUMAR SISODIYA
BHMS, MD(MEDICINE), PhD(Sch)

2. 0edema/Edema
 Edema is defined as excessive abnormal fluid
accumulation in extravascular area ( interstitial space
and serous cavity of the body) k/a oedema

3. Oedema: Causes
1. Increased Hydrostatic Pressure
I. Congestive heart failure
II. Constrictive pericarditis
III. Ascites (liver cirrhosis)
IV. Venous obstruction or compression
• Thrombosis,
• External pressure (e.g., mass),
• Lower extremity inactivity with prolonged dependency
V. Arteriolar dilation
• Heat,
VI. Fluid overload
• IV salaination
• Excess intake of water

4. 2. Reduced Plasma Osmotic Pressure (Hypoproteinemia)
1. Protein-losing glomerulopathies (nephrotic syndrome)
2. Liver cirrhosis (ascites)
3. Malnutrition Protein
4. losing Gastroenteropathy •
3. Lymphatic Obstruction
1. Inflammatory
2. Neoplastic
3. Postsurgical
4. parasitic ( Filariasis)
4. Sodium Retention
1. Excessive salt intake with renal insufficiency
2. Increased tubular reabsorption of sodium •
5. Inflammation
1. Acute inflammation
2. Chronic inflammation

5. INCREASED CAPILLARY HYDROSTATIC
PRESSURE
Rise in hydrostatic pressure at the venular end of capillaries to a
level more than plasma oncotic pressure
Minimal/ No reabsorption of fluid at venular end
EDEMA

6. Reduced Plasma Oncotic Pressure
Reduced albumin synthesis in liver / protein malnutrition
Fall in plasma oncotic pressure
Net movement of fluid into interstitial tissues
EDEMA

7. INFLAMMATION
Capillary endothelial injury by toxins/ histamine/ anoxia/ drugs
Endothelial gap
↑ Capillary permeability to plasma proteins
↓Plasma oncotic pressure
EDEMA

8. LYMPHATIC OBSTRUCTION
Impaired lymphatic drainage
Localized LYMPHOEDEMA
(E.g.:- Pressure on main lymph ducts; Inflammation of lymphatics;
Occlusion of lymphatics by malignant cells; Filariasis)

9. SODIUM & WATER RETENTION
HYPOVOLEMIA
Renal Vasoconstriction Renin ↑ADH
↓GFR Aldosterone Reabsor. of H2O ↓
RENAL RETENTION OF NA & WATER
Edema

10. Classification of edema
1. On the basis of involvement
1. Localized edema
2. Generalized edema
2. On the basis of inflammation
1. Inflammatory/ Exudative edema Inflammatory
2. Non inflammatory/Transudative edema
3. Clinical Classification
1. Pitting edema
2. Non pitting edema

15. Management
a. Get plenty of movement to increase circulation in your body
b. Frequently raise the affected area of your body, so that it is above the level of your heart
c. Massage the area affected by edema
d. Use bandages or compression socks to keep pressure on the edema
e. Consume less salt
f. Keep the swollen area clean, dry, and moisturize