Peripheral oedema is the presence of excess interstitial fluid in the tissue of the extremities, which causes palpable swelling. Oedema develops when microvascular filtration, and therefore interstitial fluid production, exceeds lymph drainage for a sustained period. This could be because the microvascular filtration rate is high, lymph flow is low, or both.
The body has a number of homeostatic mechanisms that serve to maintain interstitial fluid balance, and these must be overwhelmed before fluid build-up becomes evident as peripheral oedema. Clues generated by the history, physical examination, and targeted evaluation help to identify the factors affecting lymphatic drainage and microvascular filtration. In many patients, multiple factors contribute to the development of peripheral oedema.
Peripheral oedema is called lymphoedema when it is predominantly caused by inadequate lymphatic drainage.
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- Tricuspid regurgitation
- Sleep apnoea
- Non-thrombotic venous outflow obstruction/May-Thurner syndrome
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- Renal failure
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- Primary lymphoedema
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Associate Professor, College of Nursing
University of Colorado Anschutz Medical Campus
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Professor of Medicine
Division of Hospital Medicine
Department of Internal Medicine
University of Colorado
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Department of Cardiology
University of Texas MD Anderson Cancer Center
SWY declares that he has no competing interests.
Basic Physician Trainee RACP
PR declares that he has no competing interests.
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