International journal of obstetric anesthesia
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Int J Obstet Anesth · Feb 2024
Maldistribution of fluid in preeclampsia: a secondary kinetic analysis.
Hypovolemia and peripheral edema are frequent components of preeclampsia. The level of the dysregulation of the body fluid distribution is unclear, which complicates the choice of infusion fluid during surgery. The present fluid kinetic study challenges whether the maldistribution of fluid is due to increased capillary leakage or to poor return of already distributed fluid, which occurs via lymphatic pathways. ⋯ Decreased flow of extravascular fluid to the plasma was the key disturbance in women with preeclampsia. Such decreased flow alone promotes hypovolemia, peripheral edema, and hypoalbuminemia, and may be explained by inhibition of lymphatic pumping and/or a decreased interstitial hydrostatic pressure due to the presence of vasoactive and inflammatory signal molecules. The moderately accelerated urine flow may be due to "pressure diuresis" in response to hypertension.
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Int J Obstet Anesth · Feb 2024
Letter Case ReportsAcute Sheehan syndrome revealed by neuropsychiatric disorders.