Evaluation and management of edema in children
- Rudolph P Valentini, MD
Rudolph P Valentini, MD
- Professor of Pediatrics
- Wayne State University School of Medicine
Edema is a clinical condition characterized by an increase in interstitial fluid volume and tissue swelling that can be either localized or generalized. Severe generalized edema is known as anasarca. More localized interstitial fluid collections include ascites and pleural effusions.
The diagnostic approach to edema is based upon a thoughtful approach to the pathogenesis of its formation. Once a diagnosis is established, specific treatment of the underlying disorder can be given. If specific therapy is not available, general treatment such as optimization of fluid management can be considered.
The evaluation and management of edema in children will be presented in this topic review. The pathogenesis and etiology of edema in children are discussed separately. (See "Pathophysiology and etiology of edema in children".)
CLINICAL MANIFESTATIONS AND EVALUATION
The goals of the evaluation of a child with edema include the following:
●Determine the underlying pathophysiology, character of the edema (localized or generalized), and cause, as it will guide both evaluation and treatment (table 1). A more detailed discussion on the etiology based on the pathogenesis of the edema is presented separately. (See "Pathophysiology and etiology of edema in children".)
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- CLINICAL MANIFESTATIONS AND EVALUATION
- Physical examination
- - Edema
- Clues from constellations of symptoms and signs
- Laboratory evaluation
- - Urinalysis
- - Serum laboratory tests
- Imaging studies
- - Renal ultrasonography
- - Doppler ultrasonography
- - Chest radiography
- - Echocardiography
- Renal biopsy
- General treatment approach
- - Sodium and fluid restriction
- - Diuretics
- Intravenous albumin infusion
- SUMMARY AND RECOMMENDATIONS
- - Laboratory testing