ReviewCritical care (London, England)2023
Hypovolemia with peripheral edema: What is wrong?
Review in Critical care (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
36 citing papers in PubMed, 49 citations in OpenAlex.
- Blood volume and hemodynamics during treatment of major hemorrhage with Ringer solution, 5% albumin, and 20% albumin: a single-center randomized controlled trial.Critical care (London, England) · 2024Trial
- Combined ultrasonographic and clinical assessment of bioimpedance-defined volume status in dialysis patients: a diagnostic accuracy study.Journal of ultrasound · 2026Article
- Drowning the kidneys: from fluid overload to physiology-guided fluid management in onco-hematology.Clinical kidney journal · 2026Review
- Early Norepinephrine Attenuates Fluid-Associated Albumin Decline in Sepsis: A Prospective Longitudinal Study.Journal of clinical medicine · 2026Article
- Hypovolemic Shock in the Setting of Third Spacing with Concentric Left Ventricular Hypertrophy: A Physiology-Guided Management of Fluid Resuscitation-Case Report and Literature Review.Pathophysiology : the official journal of the International Society for Pathophysiology · 2026Article
- A nomogram model for predicting acute kidney injury in critically ill patients with upper gastrointestinal bleeding: a study based on the MIMIC-IV database and external validation.BMC gastroenterology · 2026Article
- Albumin 20% in surgical and critically ill patients; a comprehensive review.Critical care (London, England) · 2026Review
- The fluid paradox: dissociation between clinical and ultrasound parameters of fluid overload - results of the INCIVEX exploratory study.Anaesthesiology intensive therapy · 2026Observational
- Perioperative fluid management in older trauma patients : Practical algorithms and statement of the Working Group on Geriatric Traumatology of the German Society for Geriatrics.Zeitschrift fur Gerontologie und Geriatrie · 2026Review
- Vasoactive drugs and the distribution of crystalloid fluid during acute sepsis.Journal of intensive medicine · 2026Article
- A predictive nomogram for in-ICU deterioration of stage 1 pressure injuries: a retrospective study.Frontiers in medicine · 2026Article
- Hypertensive crisis in the critically ill.Annals of intensive care · 2026Review
- Endothelial Surface Glycocalyx in Vascular Functions and Diseases.Advances in experimental medicine and biology · 2026Review
- Population Pharmacokinetics and Dosing Regimen Optimization of Piperacillin in Critically Ill Patients.Drug design, development and therapy · 2026Article
- How to perform fluid de-escalation in critical care.Annals of intensive care · 2026Review
- Creatinine-to-albumin ratio and all-cause mortality in patients with upper gastrointestinal bleeding: a retrospective study.BMC gastroenterology · 2025Article
- When does the "third fluid space" open?Pflugers Archiv : European journal of physiology · 2025Article
- Physiology and Molecular Mechanisms of the "Third Fluid Space".Journal of clinical medicine · 2025Review
- Where does the fluid go?Annals of intensive care · 2025Review
- More intravascular volume, less edema: pressure therapy for the management of capillary leakage and fluid accumulation.Annals of intensive care · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Fluid normally exchanges freely between the plasma and interstitial space and is returned primarily via the lymphatic system. This balance can be disturbed by diseases and medications. In inflammatory disease states, such as sepsis, the return flow of fluid from the interstitial space to the plasma seems to be very slow, which promotes the well-known triad of hypovolemia, hypoalbuminemia, and peripheral edema. Similarly, general anesthesia, for example, even without mechanical ventilation, increases accumulation of infused crystalloid fluid in a slowly equilibrating fraction of the extravascular compartment. Herein, we have combined data from fluid kinetic trials with previously unconnected mechanisms of inflammation, interstitial fluid physiology and lymphatic pathology to synthesize a novel explanation for common and clinically relevant examples of circulatory dysregulation. Experimental studies suggest that two key mechanisms contribute to the combination of hypovolemia, hypoalbuminemia and edema; (1) acute lowering of the interstitial pressure by inflammatory mediators such as TNFα, IL-1β, and IL-6 and, (2) nitric oxide-induced inhibition of intrinsic lymphatic pumping.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.