Fluid Physiology

I was recently asked this excellent question by a neuro-intensivist working in the USA.  I’m confident he knows more about the blood-brain barrier than I do, but here are my own thoughts on the topic. Firstly, it’s complicated. A nice experiment on six acute brain trauma patients reported in 2012 showed that

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

Still awaiting proofs for my own chapter in Farag & Kurz’ anaesthetic textbook, we have been beaten to the bookshops by the surgical equivalent. But with John Myburgh as senior author I feel honoured to be amongst his august Reference list;   9. Starling E. On the absorption of fluids

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

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

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

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

A dozen years have passed since  the team at University of California, Davis, confirmed by elegant experiment Michel and Weinbaum’s  steady-state Starling principle. Review articles have been published and important advances made in our understanding of the regulation of the plasma volume, which followers of this website understand is a

Tuesday June 7, Cochrane ACE hosted 41 delegates at the Royal College of Anaethetists in London. As part of the educational program we were invited to critically-appraise the intervention Review; Burdett E, Dushianthan A, Bennett-Guerrero E, Cro S, Gan TJ, Grocott MPW, James MFM, Mythen MG, O’Malley CMN, Roche AM,