Bilirubin in Edema Fluids in Cardiac Decompensation

Meakins 1 stated that edema fluids in patients with cardiac decompensation contain no bilirubin and attempted to correlate this finding with the distribution of jaundice in patients with congestive failure. Andrews, 2 however, had previously reported the presence of appreciable amounts of bilirubin in the ascitic fluid of a patient with cardiac decompensation.

In the present studies edema fluids from various body spaces taken from 8 patients with cardiac edema were examined. Fluids and blood were withdrawn from the patient within a few minutes of each other. The method of Van den Bergh as modified by McNee and Keefer 3 was used in estimating the serum and edema fluid bilirubin contents; the protein concentrations were measured by the macrokjeldahl method according to Dyer 4 (non-protein nitrogen was subtracted from total nitrogen).

The serum bilirubin concentration ranged from 0.6 mg. % to 2.8 mg.; %; that of the edema fluids varied from a trace to 1.3 mg. %. Bilirubin was found in every specimen of edema fluid; the edema fluid bilirubin content was lower than that of the serum in each instance. The data suggest that there is a correlation between the bilirubin content of the edema fluid and of the serum, and also that for a given concentration of bilirubin in the serum, its concentration in the edema fluid is in general higher, the higher the protein content of the fluid.