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The effects of gravity and compression on interstitial fluid transport in the lower limb
Edema in the limbs can arise from pathologies such as elevated capillary pressures due to failure of venous valves, elevated capillary permeability from local inflammation, and insufficient fluid clearance by the lymphatic system. The most common treatments include elevation of the limb, compression...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8941011/ https://www.ncbi.nlm.nih.gov/pubmed/35318426 http://dx.doi.org/10.1038/s41598-022-09028-9 |
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author | Baish, James W. Padera, Timothy P. Munn, Lance L. |
author_facet | Baish, James W. Padera, Timothy P. Munn, Lance L. |
author_sort | Baish, James W. |
collection | PubMed |
description | Edema in the limbs can arise from pathologies such as elevated capillary pressures due to failure of venous valves, elevated capillary permeability from local inflammation, and insufficient fluid clearance by the lymphatic system. The most common treatments include elevation of the limb, compression wraps and manual lymphatic drainage therapy. To better understand these clinical situations, we have developed a comprehensive model of the solid and fluid mechanics of a lower limb that includes the effects of gravity. The local fluid balance in the interstitial space includes a source from the capillaries, a sink due to lymphatic clearance, and movement through the interstitial space due to both gravity and gradients in interstitial fluid pressure (IFP). From dimensional analysis and numerical solutions of the governing equations we have identified several parameter groups that determine the essential length and time scales involved. We find that gravity can have dramatic effects on the fluid balance in the limb with the possibility that a positive feedback loop can develop that facilitates chronic edema. This process involves localized tissue swelling which increases the hydraulic conductivity, thus allowing the movement of interstitial fluid vertically throughout the limb due to gravity and causing further swelling. The presence of a compression wrap can interrupt this feedback loop. We find that only by modeling the complex interplay between the solid and fluid mechanics can we adequately investigate edema development and treatment in a gravity dependent limb. |
format | Online Article Text |
id | pubmed-8941011 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-89410112022-03-28 The effects of gravity and compression on interstitial fluid transport in the lower limb Baish, James W. Padera, Timothy P. Munn, Lance L. Sci Rep Article Edema in the limbs can arise from pathologies such as elevated capillary pressures due to failure of venous valves, elevated capillary permeability from local inflammation, and insufficient fluid clearance by the lymphatic system. The most common treatments include elevation of the limb, compression wraps and manual lymphatic drainage therapy. To better understand these clinical situations, we have developed a comprehensive model of the solid and fluid mechanics of a lower limb that includes the effects of gravity. The local fluid balance in the interstitial space includes a source from the capillaries, a sink due to lymphatic clearance, and movement through the interstitial space due to both gravity and gradients in interstitial fluid pressure (IFP). From dimensional analysis and numerical solutions of the governing equations we have identified several parameter groups that determine the essential length and time scales involved. We find that gravity can have dramatic effects on the fluid balance in the limb with the possibility that a positive feedback loop can develop that facilitates chronic edema. This process involves localized tissue swelling which increases the hydraulic conductivity, thus allowing the movement of interstitial fluid vertically throughout the limb due to gravity and causing further swelling. The presence of a compression wrap can interrupt this feedback loop. We find that only by modeling the complex interplay between the solid and fluid mechanics can we adequately investigate edema development and treatment in a gravity dependent limb. Nature Publishing Group UK 2022-03-22 /pmc/articles/PMC8941011/ /pubmed/35318426 http://dx.doi.org/10.1038/s41598-022-09028-9 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Baish, James W. Padera, Timothy P. Munn, Lance L. The effects of gravity and compression on interstitial fluid transport in the lower limb |
title | The effects of gravity and compression on interstitial fluid transport in the lower limb |
title_full | The effects of gravity and compression on interstitial fluid transport in the lower limb |
title_fullStr | The effects of gravity and compression on interstitial fluid transport in the lower limb |
title_full_unstemmed | The effects of gravity and compression on interstitial fluid transport in the lower limb |
title_short | The effects of gravity and compression on interstitial fluid transport in the lower limb |
title_sort | effects of gravity and compression on interstitial fluid transport in the lower limb |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8941011/ https://www.ncbi.nlm.nih.gov/pubmed/35318426 http://dx.doi.org/10.1038/s41598-022-09028-9 |
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