Self evident is a patient's struggles to survive when 40 pounds of edema loads an ICU patient . He can't even bend his arms! A ventilator struggles to push aside edema fluid.
Emergency Room started "normal" saline IV. A swelled abdomen squeezed kidneys, slowing blood flow--a strong signal to retain salt and water. Urine output falls. Speed the IV. Abdomen grows tighter--speed the IV! A viscous cycle is started.
Instead raise serum albumin by giving 25%--moves fluids from edema to vessels. 25% moves fluid from where excess intercellular fluid clogs the system instead 25% moves fluid into vessels where fluid is needed. Important point! You want proof? Check urine Na on a random spec from the catheter of an edematous patient--Na almost absent. Check after 25% albumin. Urine Na will rise. Higher urine Na is a sign to you that kidneys release Na, and edema, because of better renal blood flow.
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