[Severina]

Does anyone know a site where, or somewhere I can get info on the phenomena of third spacing at end of life? I looked at my nursing text and it only mentioned it once, but in connection with burns. I'm trying to understand how this happens and why, and the pathophysiology involved.

Severina

[earle58]

third spacing depends on the etiology but the end result is hypovolemia. fluids are pulled from your vessels as colloids seep into soft tissue...the oncotic pressure of the colloids leaving the vasculature pulls the fluid out along with it.
third spacing happens with many different pathologies; renal, cardiac, hepatic, shock, sepsis so each mechanism will be contigent on the etiology. but the bottom line is that it leaves the patient hypovolemic.

leslie

[aimeee]

http://www.nursingcenter.com/prodev/...asp?tid=416664

Just a mention here. Doesn't really delve into the physiology of it.

[Severina]

Thanks for this. Great article.

[NRSKarenRN]

Good explanation Earle. That WAS a great article Aimee:

Dying patients often have decreased protein levels in the blood; this shifts the plasma's osmotic pressure, causing fluid to leak from the vasculature, and leads to lymphatic congestion. 7

7. Guyton AC, Hall JE. Pulmonary circulation; pulmonary edema; pleural fluid. In: Textbook of medical physiology. 9th ed. Philadelphia: W.B. Saunders; 1996. p. 491–9. [Context Link]

:hatparty: Glad I don't have to haul out my Guyton physiology book.

[earle58]

aimee- that was a great article, well written.
i've now added nursing center to my favorites list.

leslie