Does a low serum albumin mean that the patient will become edematous?
Edema formation is determined by the rate of fluid flux: COP is determined by total protein concentration, and the state of the lymphatic system. The formation of edema is determined by: The rate of fluid flux The clearance of fluid by lymphatics. In critical illness, there is a stronger correlation between colloid oncotic pressure and total protein than with albumin. In these patients the decreased albumin is compensated for by an increase in acute phase proteins. Nonetheless, there is increased leakage of albumin and this drags fluid with it. The overall fluid flux is less than would be predicted if albumin was the only protein responsible for oncotic pressure in the Starling equation. Lymphoid function is important – if it is overwhelmed by increased capillary permeability or fluid flux, then edema will occur. It is likely that lymphoid dysfunction plays a significant role in edema formation in critical illness. There has been some speculation that lymphoid dysfunction is caused by
