3rd Spacing Edema

Increased hydrostatic
pressure as a result of venous
obstruction or increased salt
and water retention. Loss of
Trauma (as well as bacterial/viral plasma proteins due to burns,
infections), shock, burns, sepsis etc… cirrosis of the liver,
basically illness or trauma. It is common malnutrition. Decreased
is patients who have just had major drainage of the lymphatics
Cause surgery. (lymphedema).
From circulating blood collects between
the skin and fascia, or other body
compartments where fluids do not excessive accumulation of
normally collect. It is unavailable for fluid within the interstitial
Excess Fluid metabolic processes. spaces (ECF).
edema results from
Results in Hypovolemia, dehydration hypervolemia
Congestive heart failure and
renal failure are associated
with salt and water retention,
Most often the peritoneal cavity (the which cause plasma volume
serous membrane that forms the lining of overload, increased capillary
the abdominal cavity) or the intestines as hydrostatic pressure, and
Common in well as renal and cardiac disfunction. edema.
In general, third spacing is dealt with by
correction of the *underlying* illness or
disturbance that is causing it (you Water from the intracellular
generally don’t actually treat the third space has moved to the
spacing itself). By giving the patient more extracellular space until the
fluids and correcting the electrolyte and osmotic forces are equal. The
protein imbalances, you are only consequence is a decrease in
correcting the symptoms in the short ICF water volume and cell
term. In the example of a surgical size. ICF, Intracellular fluid;
patient, the third spacing goes away on ECF, extracellular fluid.
its own. In the example of a patient with Diuretics are frequently used
sepsis, when you aggressively treat the to treat pathologic conditions
source of infection, the third spacing will in which fluid overload or
Pathophysiology gradually resolve. edema has occurred.