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مراجعة من قبل الدكتور كريشنا فاخاريا، MRCGPآخر تحديث بواسطة الدكتورة هايلي ويلاسي، زميلة الكلية الملكية للأطباء العامين آخر تحديث 31 أكتوبر 2022
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في هذه السلسلة:فشل القلب الاحتقانيمدرات البول العروية
Fluid overload means that there is too much fluid in the body. The increased level of fluid results in an excessive amount of fluid flowing around the circulatory system. This can overwork the heart and lead to فشل القلب.
نظرة سريعة
Fluid overload is when there is too much fluid in the body.
It can cause breathlessness due to waterlogging of the lungs.
Swelling in the lower legs that leaves a pit when pressed is a symptom.
Heart failure and kidney problems can cause fluid overload.
Treatment for fluid overload may include 'water tablets' or restricting fluid intake.
Fluid overload symptoms
The excess fluid circulating around the body can cause waterlogging of the lungs, leading to breathlessness. The medical term for this is acute pulmonary oedema. 'Acute' means 'of quick onset'.
Alternatively the overloading process can occur over a longer period of time and cause additional symptoms like swelling in the lower leg and ارتفاع ضغط الدم. The type of swelling that occurs in the legs is called pitting oedema. This means that when the swelling is pressed with a finger, it leaves an indentation, or a 'pit'.
Can fluid overload cause death?
This depends on the cause of the fluid overload - how serious it is and and whether it can be treated.
Even if the fluid overload is not caused by a heart condition, if it is not treated the extra pressure on the heart eventually leads to فشل القلب. This causes tiredness, shortness of breath and swelling of the legs and feet. Heart failure is a complex condition which can result in a lower life expectancy for some.
What causes fluid overload?
The heart and kidneys interact to control fluid volume and the sodium content in the body. This system is quite complex.
Treatment with fluid can be a cause. It is sometimes difficult to calculate how much fluid the body needs. This can happen when nutritional fluid or blood is given through a drip. The risk of overload may be increased if you are elderly, you have had a major injury or operation, or your kidneys or heart do not work as well as they should,
Sometimes the problem is not so much extra fluid as too much sodium. Sodium is a chemical that occurs naturally in the body and needs to be at a certain level in the blood and other body fluids. If too much sodium is given, the body will retain water to try to correct this.
People with heart failure may have fluid overload,
People whose kidneys suddenly stop working properly (acute kidney injury أو مرض الكلى المزمن) can be similarly affected.
How is fluid overload diagnosed?
A number of conditions produce signs and symptoms that resemble fluid overload, and these need to be excluded. These conditions include:
Lung problems, such as blood clots, infections, الربو.
Heart problems, such as inflammation of the covering of the heart (التهاب التامور).
Problems with the venous circulation or lymphatic circulation.
Metabolic disorders causing a low protein level in the blood (hypoproteinaemia).
مرض الكبد.
Thyroid disease.
مرض الكلى.
هل سأحتاج إلى أي اختبارات؟
It's not surprising that with all these conditions to rule out you may need several tests. These may include:
Heart tests: تخطيط القلب (تخطيط كهربية القلب، أو ECG) و ultrasound scanning of the heart (echocardiogram, or echo).
Blood tests to check your kidney function, blood count, liver function, blood gases.
A special test for heart failure, called B-type natriuretic peptide (BNP).
Charts to check how much you drink and pee and any weight changes in response to treatment.
How to treat fluid overload
The treatment depends on your symptoms and the underlying cause. The possible treatments include:
'Water tablets' (diuretics): see the leaflets on Loop Diuretics و Thiazide Diuretics for more information.
Mineralocorticoid/aldosterone receptor antagonists (MRAs) - eg, spironolactone و eplerenone - like diuretics, also prevent the build-up of fluid.
In some situations you may be advised to restrict fluid or salt intake.
You may be asked to weigh yourself daily.
Other treatments such as dialysis may also be needed for severe fluid overload.
What is the outlook for fluid overload?
This depends on the underlying cause and how well you were before the fluid overload occurred. For example:
If the fluid overload was due to a problem with your heart, the outlook (prognosis) depends on how treatable your heart condition is.
If the fluid overload resulted from being given too much fluid during intravenous treatment, the outlook will depend on the reason why you needed a drip in the first place.
If you were given it because you had just had a simple operation but were well beforehand, the outlook should be good once the overload is corrected.
However, if intravenous treatment was given because you had a serious problem such as extensive burns, correcting the overload may be more complicated.
اختيارات المرضى لـ فشل القلب

صحة القلب والأوعية الدموية
فشل القلب الاحتقاني
Heart failure does not mean that your heart has stopped or is going to stop at any minute. It means that your heart is not functioning as well as it should. Heart failure can be caused by many different conditions. Symptoms include fluid retention, breathlessness and tiredness. Medication can usually ease symptoms and can often improve the outlook.
بقلم الدكتور كولين تايدي، MRCGP

صحة القلب والأوعية الدموية
الوذمة الرئوية
Pulmonary oedema is an excess of watery fluid in the lungs. People with sudden onset of pulmonary oedema usually need urgent admission to hospital. Treatment includes oxygen, medicines to remove the excess fluid from the lungs (diuretics), and other medicines to help the heart work more effectively. Further treatment will depend on the cause of the pulmonary oedema. Pulmonary oedema may be life-threatening, especially without urgent medical treatment.
بقلم الدكتورة روزالين أدلمان، MRCGP
الأسئلة الشائعة
What is the medical name for waterlogging of the lungs caused by fluid overload?
Waterlogging of the lungs due to fluid overload is medically termed acute pulmonary oedema. The word 'acute' indicates that the condition has a quick onset.
What specifically is 'pitting oedema'?
Pitting oedema refers to a type of swelling, often in the lower legs, where pressing the swollen area with a finger leaves a temporary indent or 'pit'.
How can an imbalance of sodium lead to fluid overload?
If there is too much sodium in the body, the body will retain water to try and correct this imbalance. The body's systems, particularly involving the heart and kidneys, work to maintain a specific level of sodium in the blood and other bodily fluids.
Are there specific dietary recommendations for managing fluid overload?
Yes, in certain situations, you may be advised to restrict your fluid or salt intake as part of the treatment for fluid overload. The specific recommendations would depend on the underlying cause and your individual symptoms.
Why might weighing myself daily be recommended for fluid overload?
Daily weighing can help monitor changes in your body's fluid levels, as weight fluctuations can indicate how your body is responding to treatment for fluid overload.
قراءة إضافية ومراجع
- Messmer AS, Zingg C, Muller M, et al; Fluid Overload and Mortality in Adult Critical Care Patients-A Systematic Review and Meta-Analysis of Observational Studies. Crit Care Med. 2020 Dec;48(12):1862-1870. doi: 10.1097/CCM.0000000000004617.
- Perez Nieto OR, Wong A, Lopez Fermin J, et al; Aiming for zero fluid accumulation: First, do no harm. Anaesthesiol Intensive Ther. 2021;53(2):162-178. doi: 10.5114/ait.2021.105252.
- Raina R, Sethi SK, Wadhwani N, et al; Fluid Overload in Critically Ill Children. Front Pediatr. 2018 Oct 29;6:306. doi: 10.3389/fped.2018.00306. eCollection 2018.
- Zoccali C, Moissl U, Chazot C, et al; Chronic Fluid Overload and Mortality in ESRD. J Am Soc Nephrol. 2017 Aug;28(8):2491-2497. doi: 10.1681/ASN.2016121341. Epub 2017 May 4.
عن المؤلفعرض السيرة الذاتية الكاملة

الدكتور لورانس نوت
طبيب عام، مؤلف طبي
بكالوريوس (مع مرتبة الشرف) في الكيمياء الحيوية، بكالوريوس الطب والجراحة
الدكتور لورانس نوت تأهل في عام 1973 ولديه خبرة واسعة كطبيب عام.
حول المراجععرض السيرة الذاتية الكاملة

الدكتور كريشنا فاخاريا، MRCGP
كبير المسؤولين الطبيين للصحة، أوبتوم المملكة المتحدة
MBChB, MRCGP(2013), BMedSci (hons), DFSRH, DRCOG, PGDipDerm (Distn)
الدكتورة كريشنا فاخاريا هي طبيبة عامة في هيئة الخدمات الصحية الوطنية. كما أنها ممتحنة منتظمة لدبلوم الدراسات العليا في الأمراض الجلدية العملية في جامعة كارديف، بالإضافة إلى كونها كبيرة المسؤولين الطبيين للصحة في Optum UK.
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تمت كتابة المعلومات على هذه الصفحة ومراجعتها من قبل أطباء مؤهلين.
المقال متاح أيضًا باللغة الإنجليزية, الألمانية, إسبانية, الفرنسية, إيطالي, البرتغالية, الهندية, العبرية, العربية ,، و السويدية.
المراجعة التالية مستحقة: 30 أكتوبر 2027
31 أكتوبر 2022 | أحدث إصدار
آخر تحديث بواسطة
الدكتورة هايلي ويلاسي، زميلة الكلية الملكية للأطباء العامينمراجعة من قبل
الدكتور كريشنا فاخاريا، MRCGP9 Jul 2017 | نُشر في الأصل
كتبه:
الدكتور لورانس نوت

اسأل، شارك، تواصل.
تصفح المناقشات، اطرح الأسئلة، وشارك التجارب عبر مئات المواضيع الصحية.

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المزيد في صحة القلب والأوعية الدموية
- الأسبرين والأدوية المضادة للصفائح الدموية الأخرى
- الرجفان الأذيني والوقاية من السكتة الدماغية
- حاصرات بيتا
- بطء القلب
- تصوير الأوعية التاجية
- تشنج الشريان التاجي
- تخطيط صدى القلب
- فرط كوليسترول الدم العائلي
- التهاب الشرايين ذو الخلايا العملاقة
- التهاب الأوعية الدموية الحبيبي مع التهاب الأوعية
- خفقان القلب
- فرفرية هينوخ-شونلاين
- ارتفاع ضغط الدم
- ارتفاع ضغط الدم أثناء الحمل
- التهاب الشغاف العدوائي
- التعايش مع ارتفاع ضغط الدم
- تضيق الصمام التاجي
- مرض الشرايين المحيطية
- متلازمة تسارع ضربات القلب الوضعي
- النوبة الإقفارية العابرة