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As a result, associated symptoms include edema in the lower legs, ascites in the abdomen, and effusions around internal organs. Laboratory tests aimed at assessing liver function diagnose hypoalbuminemia. Once identified, it is a poor prognostic indicator for patients with a variety of different diseases.
Chronic venous insufficiency (CVI) is a medical condition characterized by blood pooling in the veins, leading to increased pressure and strain on the vein walls. [1] The most common cause of CVI is superficial venous reflux, which often results in the formation of varicose veins, a treatable condition. [2]
The ulcers are caused by lack of blood flow to the capillary beds of the lower extremities. Most often endothelial dysfunction is causative factor in diabetic microangiopathy and macroangiopathy. [2] In microangiopathy, neuropathy and autoregulation of capillaries leads to poor perfusion of tissues, especially wound base.
Acute limb ischaemia (ALI) occurs when there is a sudden lack of blood flow to a limb [1] within 14 days of symptoms onset. [2] On the other hand, when the symptoms exceed 14 days, [3] it is called critical limb ischemia (CLI).
Critical limb ischemia is diagnosed by the presence of ischemic rest pain, and an ulcers that will not heal or gangrene due to insufficient blood flow. [3] Insufficient blood flow may be confirmed by ankle-brachial index (ABI), ankle pressure, toe-brachial index (TBI), toe systolic pressure, transcutaneous oxygen measurement (TcpO2 ), or skin perfusion pressure (SPP).
The body in hypovolemic shock prioritizes getting oxygen to the brain and heart, which reduces blood flow to nonvital organs and extremities, causing them to grow cold, look mottled, and exhibit delayed capillary refill. [3] The lack of adequate oxygen delivery ultimately leads to a worsening increase in the acidity of the blood (acidosis). [3]
Temperature – cool suggest poor circulation, sides should be compared; Pitting edema – should be tested for in dependent locations – dorsum of foot, if present then on the shins. If the patient has been in bed for a longer period of time one should check the sacrum. Capillary refill – should be less than 3 seconds.
The signs and symptoms of ischemia vary, as they can occur anywhere in the body and depend on the degree to which blood flow is interrupted. [4] For example, clinical manifestations of acute limb ischemia (which can be summarized as the "six P's") include pain, pallor, pulseless, paresthesia, paralysis, and poikilothermia.