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Edema is the accumulation of fluid in tissues. It is caused by an imbalance between forces holding fluids in the vasculature and tissues. Fluids are normally held in a steady state between tissues and vasculature by homeostasis between these forces (Starling equation) :

  • capillary hydrostatic pressure - drives fluid out of the vasculature into tissues
  • plasma colloid osmotic pressure - keeps fluid in the vasculature, preventing extravasation into the tissues
  • tissue colloid osmotic pressure - keeps fluid in the tissues

Clinical presentation

Pathology

Etiology
  • increased capillary hydrostatic pressure
  • reduced plasma colloid osmotic pressure
  • increased tissue colloid osmotic pressure
  • increased vascular permeability
    • inflammation
    • infection
  • reduced lymphatic clearance
  • increased salt retention (causes both increased hydrostatic pressure and reduced plasma colloid osmotic pressure by fluid retention)
    • renal insufficiency
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