TITLE:
Volumetric Overload Shocks: Why Is Starling’s Law for Capillary Interstitial Fluid Transfer Wrong? The Hydrodynamics of a Porous Orifice Tube as Alternative
AUTHORS:
Ahmed N. Ghanem, Salma A. Ghanem
KEYWORDS:
Shock, The Multiple Vital Organs Dysfunction or Failure Syndrome, The Adult Respiratory Distress Syndrome, The Transurethral Resection of the Prostate Syndrome, Hyponatraemia
JOURNAL NAME:
Surgical Science,
Vol.7 No.6,
June
3,
2016
ABSTRACT: Based on
clinical and experimental work two new types of volumetric overload shocks are
reported: volumetric
overload shock type one and type two depending on the type of fluid causing
their induction. Volumetric overload shock type one is induced by sodium-free
fluids such as glycine, glucose, mannitol and sorbitol and is characterized with acute dilutional hyponatraemia.
Volumetric overload shock type 2 is induced with sodium-based fluids normal
saline and plasma substitutes used for resuscitation of the critically ill and
has no serological marker. It presents with the multiple vital organs
dysfunction or failure syndrome or the adult respiratory distress syndrome.
Hypertonic sodium is an effective treatment when given early adequately. The underlying
pathophysiology is discussed. An alternative to Starling’s law for the
capillary interstitial fluid transfer is given. Hydrodynamic of a porous
orifice tube akin to capillary with a surrounding Chamber akin to the
interstitial fluid space demonstrated a rapid dynamic magnetic field-like fluid
circulation between the surrounding chamber and the lumen of the G tube that
represent an adequate replacement for Starling’s law.