Hemodynamic effects of massive peripheral edema

• Published in: The American heart journal Vol. 105; no. 1; pp. 90 - 97
• Main Authors: Magrini, Fabio, Niarchos, Andreas P.
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 1983
• Subjects: Adult; Blood Pressure; Blood Volume; Cardiac Output; Diuretics - therapeutic use; Edema - drug therapy; Edema - physiopathology; Hemodynamics; Humans; Male; Middle Aged; Posture; Space life sciences; Stroke Volume; Vascular Resistance
• ISSN: 0002-8703; 1097-6744
• DOI: 10.1016/0002-8703(83)90283-1

The possibility that noncardiac massive peripheral edema reduces venous distensibility was investigated in eight patients in the supine and 80-degree head-up tilt position before and after diuretic therapy. After clearance of the edema with diuretic therapy, total blood volume (TBV) was not significantly decreased; therefore, in the supine position the significant (2 p < 0.001) decrease of right atrial pressure, stroke volume, cardiac output, and cardiopulmonary blood volume (CBV) by the diuretics was due to an improvement in venous compliance which resulted in peripheral redistribution of CBV since the ratio CBV TBV was decreased during diuretic therapy (2 p < 0.001). Furthermore, before diuretic therapy, tilt significantly decreased right atrial pressure, stroke volume, cardiac output, CBV, and the ratio CBV TBV ; but after diuretic therapy, the decrease of the same variables during tilt was significantly (2 p < 0.001) greater. These results indicate that marked peripheral edema considerably decreases venous compliance which can be improved with diuretic therapy.