Edema Essay
The body health depends in keeping body fluid in balance, which distribute between intravascular in blood vessels, and extravascular which can be inside the cell (intracellular fluid) or between the cells called (interstitial fluid). Edema occurs when the interstitial volume has increased due to fluid leaks from capillaries or tiny blood vessels to interstitial space, then the space will expand cause edema.[1]
To understand the mechanism clearly, fluid dynamic control should be considered, the hydrostatic pressure which the pressure of fluid inside the vessels against wall, moves fluid out of vessels into interstitial space, another pressure leads to moves fluid in opposite direction called oncotic pressure. Mainly edema will form if the hydrostatic pressure exceeds the oncotic pressure. Simply, edema is when abnormal excessive fluid accumulate in the body, lead to swelling extremities. Edema has different terms according to the location. Mostly in the lower extremities and abdomen because of pull of gravity.[1, 2]
Study in 2003 shows the prevalence of edema is 1.33 for each 1000 person. Prevalence Increase with age 5.4/1000 age > 65 years, and was more in women than men.[3] Physiological …show more content…
Age-related Changes that can be Risk factors for Leg Edema are decrease of all: Hepatic blood flow, glomerular filtration rate, Baroceptor sensitivity, Myocadiac contractility, Cardiac output, and Retention of fluid, Sluggish circulation. other contributing factors: positioning of Lower limbs, high sodium intake, medication like NSAID, antihypertensive.[4]
Most common causes of edema in elderly include chronic venous insufficiency, dysfunction of the valves of the vein leads to return blood to the leg, then will increase of venous pressure leads to edema, Venous insufficiency can be result from previous deep vein thromboses (DVT).[1, 5]
Lymphedema which due obstruction or decrease in number of lymphatic vessels, Lead to abnormal collection of protein-rich fluid in the interstitial resulting from obstruction of lymphatic drainage. Lymphedema can be classified to primary (idiopathic) which may related to another genetic dysfunction where lymphatic system does not grow properly. This type not common in elderly. Anne (2005) found 68% of patient who suffered from primary lymphedema are older adult.[6, 7] secondary lymphedema, when lymphatic system damaged because of many conditions that affect it like: tumor, infection, obesity, radiation therapy. one of the most common causes of secondary lymphedema In the United states is related to cancer. There is a Study found 90% of people who had lymphedema affect their lower limbs, 9% affect their upper limbs and 1% affect genital area.[1, 4, 6, 8]
Deep vein thrombosis (DVT) it can be seen in older bedridden or in cancer patients. Blood clot or (thrombus) cause limitation of blood flow through the vein lead to swelling, pain and warmth in the involved limb.[9]
Congestive heart failure it the most common cause of edema in elderly.
80% of all heart failure patients are 65 years and older. When the heart muscle weakened, it will fail to pumps blood, then the circulation will be less effectively, that leads to increase hydrostatic pressure in capillaries, the fluid will accumulate in interstitial space. When the volume of fluid exceeds the lymphatic system ability to drainage, it will form edema. Most swelling occur in legs and feet, but if the failure in the left side of the heart it will form edema in the lung, if the failure in the right side of the heart the edema will present in the periphery. Heart failure may affect the kidney, make the body retain sodium which lead to increase total body fluid, create more edema.[1, 10,
11]
Hepatic insufficiency as cirrhosis or hepatitis B and C also can cause edema, by causing retain fluid in the abdomen and limbs. Cirrhosis also leads to decrees the levels of albumin and other proteins in blood. Then Fluid leaks from vessels leads to abdomen edema (ascites) and leg edema.[10]
Medication edema common in elderly especially who has multiple prescription of drugs. include calcium channel blockers, estrogens, and nonsteroidal anti-inflammatory agents, antihypertensive.[1, 4]
To understand the mechanism clearly, fluid dynamic control should be considered, the hydrostatic pressure which the pressure of fluid inside the vessels against wall, moves fluid out of vessels into interstitial space, another pressure leads to moves fluid in opposite direction called oncotic pressure. Mainly edema will form if the hydrostatic pressure exceeds the oncotic pressure. Simply, edema is when abnormal excessive fluid accumulate in the body, lead to swelling extremities. Edema has different terms according to the location. Mostly in the lower extremities and abdomen because of pull of gravity.[1, 2]
Study in 2003 shows the prevalence of edema is 1.33 for each 1000 person. Prevalence Increase with age 5.4/1000 age > 65 years, and was more in women than men.[3] Physiological …show more content…
Age-related Changes that can be Risk factors for Leg Edema are decrease of all: Hepatic blood flow, glomerular filtration rate, Baroceptor sensitivity, Myocadiac contractility, Cardiac output, and Retention of fluid, Sluggish circulation. other contributing factors: positioning of Lower limbs, high sodium intake, medication like NSAID, antihypertensive.[4]
Most common causes of edema in elderly include chronic venous insufficiency, dysfunction of the valves of the vein leads to return blood to the leg, then will increase of venous pressure leads to edema, Venous insufficiency can be result from previous deep vein thromboses (DVT).[1, 5]
Lymphedema which due obstruction or decrease in number of lymphatic vessels, Lead to abnormal collection of protein-rich fluid in the interstitial resulting from obstruction of lymphatic drainage. Lymphedema can be classified to primary (idiopathic) which may related to another genetic dysfunction where lymphatic system does not grow properly. This type not common in elderly. Anne (2005) found 68% of patient who suffered from primary lymphedema are older adult.[6, 7] secondary lymphedema, when lymphatic system damaged because of many conditions that affect it like: tumor, infection, obesity, radiation therapy. one of the most common causes of secondary lymphedema In the United states is related to cancer. There is a Study found 90% of people who had lymphedema affect their lower limbs, 9% affect their upper limbs and 1% affect genital area.[1, 4, 6, 8]
Deep vein thrombosis (DVT) it can be seen in older bedridden or in cancer patients. Blood clot or (thrombus) cause limitation of blood flow through the vein lead to swelling, pain and warmth in the involved limb.[9]
Congestive heart failure it the most common cause of edema in elderly.
80% of all heart failure patients are 65 years and older. When the heart muscle weakened, it will fail to pumps blood, then the circulation will be less effectively, that leads to increase hydrostatic pressure in capillaries, the fluid will accumulate in interstitial space. When the volume of fluid exceeds the lymphatic system ability to drainage, it will form edema. Most swelling occur in legs and feet, but if the failure in the left side of the heart it will form edema in the lung, if the failure in the right side of the heart the edema will present in the periphery. Heart failure may affect the kidney, make the body retain sodium which lead to increase total body fluid, create more edema.[1, 10,
11]
Hepatic insufficiency as cirrhosis or hepatitis B and C also can cause edema, by causing retain fluid in the abdomen and limbs. Cirrhosis also leads to decrees the levels of albumin and other proteins in blood. Then Fluid leaks from vessels leads to abdomen edema (ascites) and leg edema.[10]
Medication edema common in elderly especially who has multiple prescription of drugs. include calcium channel blockers, estrogens, and nonsteroidal anti-inflammatory agents, antihypertensive.[1, 4]