The myth of venous return? The Venous Excess approach.

Fans of FOAMEd will doubtless welcome Critical Care’s latest educational venture into cardiovascular physiology which includes “Volume and its relationship to cardiac output and venous return” by Sheldon Magder. Critical Care 2016;20:271 DOI: 10.1186/s13054-016-1438-7 Published: 10 September 2016 I was delighted by the very last sentence of this well-written review, and recently

Venous haemodynamics Part One

A recent tweet about ATLS 10e Shock Classification  @misraasit gave me pause for thought. The message of this now-classic table is that arterial-side blood pressure may be so well defended in haemorrage that it is a poor indicator of  proximity to irreversible shock/ death. Heart rate may be raised by

NYC tracks and some hyperosmotic albumin thoughts.

I’m flattered and rather excited to be mentioned in the NYC tracks this week; https://thinkingcriticalcare.com/2016/08/03/the-nyc-tracks-with-jon-emile-the-glycocalyx-the-next-frontier-foamed-foamcc/ Great to hear how  others are progressing on their paths to steady state Starling enlightenment. I sometimes feel like a single voice against some of the Pharma-sponsored talking heads who sparkle on the international Congress

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,