Robert Hahn on the half life of fluids

Excellent educational contribution from the father of fluid kinetics has appeared in the European Journal of Anaesthesiology. I have drawn freely on Hahn’s kinetic diagrams, but have modified them to include the concept that the glycocalyx can be considered an intravascular part of the extracellular gel phase. This concept is

Magic Eye view of glycocalyx

Seeing is believing, even if what you want to see is actually unseeable.  My last post has reminded me of Kenton Arkill’s wonderful 3-D reconstruction of a rat peritubular capillary’s glycocalyx. Take a stereoscopic look; http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3808814/figure/F5/ Sad to say, I can’t see it; my eyes adapt near rather than far,

An optimistic view of OPTIMISE II?

Rupert Pearse’ OPTIMISE trial published in 2014 found that “use of a cardiac output–guided hemodynamic therapy algorithm compared with usual care did not reduce a composite outcome of complications and 30-day mortality.” My concern about the protocol was that it obliged research anaesthetists to give colloid solutions to all the

Albumin, the EGL, vascular permeability and trout fishing.

Jon-Emile Kenny is a New York physician who has recently joined the FOAMEd movement, and is opening his PulmCrit account with a blast around the steady-state Starling principle. http://pulmccm.org/main/2016/ards-review/revised-starling-principle-implications-rational-fluid-therapy/ It seems JE has read RSE&GM 2012 and is concerned about his propensity to prescribe hyperoncotic albumin with furosemide to cirrhotic

We should engineer a new crystalloid?

My post on bag wars was hardly posted when Josh Farkas’ excellent PulmCrit posted an recipe for a Universal Panacea. http://emcrit.org/pulmcrit/crystalloid/ My own foray into this arena was 19 years ago ncbi.nlm.nih.gov/pubmed/9349085 “An improved Hartmann’s solution for anaesthetists in the 1990s”. Before you read it, please note it is heavily

Faculty of 1000

Do you despair of waiting months, maybe years for Publication of research results you saw previewed at a recent Conference? Have you been frustrated by Editors who publish only positive studies in their prestigious Journal, and wondered what changes they have demanded to the submitted Manuscript? Do you wonder why