With thanks to ace Tweep @tony_breu, this is an important topic to be considered in the light of steady-state Starling physiology. Indeed I am not aware of any up-to-date review in the literature, so if one or two of you want to use this as a basis for such a
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after more than a quarter of a century of intensive care medicine consultancy in one of the UK's largest teaching hospitals Dr Woodcock is on a mission to ensure the steady state Starling principle is known and understood by every student and every practitioner.
Albumin infusion increases the volume of distribution of albumin: a randomized clinical trial in postoperative patients after major surgery
Fresh off the press from Lund, Sweden, this interesting investigation. https://ccforum.biomedcentral.com/articles/10.1186/s13054-019-2477-7 Sixty four post-surgical patients with normal heart rate and blood pressure were given human albumin solution 5% in a volume equivalent to 25% of their normal plasma volume in case they were hypovolaemic. How did that get past the
A new Twigley – Hillman diagram
While trying to direct people away from the classic Twigley – Hillman diagram and towards my kinetic diagrams it became apparent that the standard plasma/ interstitial/ intracellular compartment boxes divided by capillary wall or cell membrane is now so ingrained that I have to take a different approach. With thanks
New in 2019
The Manuscript for my Textbook is now with the Publisher, who seems keen to get it on your bookshelf as soon as possible. I shall now try to return to maintaining this website for Starling Ambassadors.
Every Hospital need Starling Ambassadors.
Reflecting on a productive few days chez Duke in Durham NC and delighted to find the ‘new’ (or maybe not so new) fluid physiology is at last gaining traction. You can get a taste at TopMedTalk thanks to my friend and some-time adversary Professor Monty Mythen. Monty is of course an academic
Fluid Physiology the Textbook coming soon
I am very grateful to visitors to this website. Social Media interaction has given me interesting questions to address, though so far no challenges to the principles of my Paradigm for Rational Fluid Prescribing. I know, everyone thinks their point of view is the rational one, but hey… I now
fluidphysiology.org – Major Revision coming soon
Dear friends and followers of fluidphysiology.org – I think this blog needs an overhaul and will soon start a bit of demolition followed by rebuilding. If there were any pearls among my posts that you would like to keep for posterity or research, now would be a good time to
Why do NHS Consultants refuse to use a licensed treatment for sepsis?
Got your attention? That’s right, I am discovering that NHS Consultants are refusing to prescribe a licensed treatment for sepsis for fear of being sued or criticised by their peers. To be exact, “Pabrinex Intravenous High Potency, Solution for injection (‘Pabrinex’) provides additional vitamins B and C to correct deficiencies
Physiology of extracellular sodium; more complicated than than we have been supposing.
I have long despaired of Experts, many of professorial appellation, who peddle the obviously oversimplified message that sodium is oedemagenic. In this post I’ll look at the growing body of work on tissue sodium, and we’ll see that plasma sodium concentration does not reflect the overall ECF sodium status. Reports
Starches Last Stand; Professor Chappell’s Keynote Lecture at Notfall Medizin 2018
Things are getting personal in the rearguard action to save the European Medicines Agency Marketing Authorisations for hydroxyethyl starch solutions. Starlingists will be familiar with my own view that ‘therapies’ based on the biophysical oncotic pressure of intravenous fluids are unlikely to make more than a short term difference to