Lone hypoalbuminemia and pulmonary edema

Q: Lone hypoalbuminemia can cause pulmonary edema?

A) True
B) False


Answer: B

There are many causes of noncardiogenic pulmonary edema including ARDS, high altitude, neurogenic pulmonary edema, opioid overdose, pulmonary embolism, eclampsia, and transfusion-related acute lung injury (TRALI), but hypoalbuminemia by itself doesn't cause pulmonary edema. This is due to the fact that the pulmonary capillaries appear to have a greater baseline permeability to albumin and therefore have a higher interstitial oncotic pressure at about 18 mmHg than do peripheral capillaries. A fall in the plasma albumin concentration is associated with a parallel decline in the pulmonary interstitial oncotic pressure. The net effect is little or no change in the transcapillary oncotic pressure gradient. Although it may increase the risk in associated diseases such as CHF.


Reference:

Taylor AE. Capillary fluid filtration. Starling forces and lymph flow. Circ Res 1981; 49:557.