Fluidphysiology returns …

A change of web host, a total website refresh. It is now 13 years since I first read Levick & Michel 2010 as I updated my presentation on Managing Fluids to the Royal College of Anaesthetists Final Fellowship Examination Preparation course. With the assistance of my son, a REAL Doctor of the physiological sciences as he tells me, I put together an all-new “paradigm for prescribers” Woodcock & Woodcock 2012. I suggest the interested student reads both of these Open Access papers carefully. Then came an invitation to explain plasma volume homeostasis and therapeutic support for BJA Education 2016. I took this opportunity to borrow from Professor Robert Hahn’s many fluid kinetic research papers and propose wider application of his fluid kinetic diagrams. Professor Hahn has been a leading critic of the extended Starling Principle, claiming that my paradigm needs confirmation in clinical situations. I am grateful to the Editors of Acta Scand for publishing our rebuttal of Professor Hahn’s concerns, along with his Response. I remain confident that our positions will be reconciled when ‘the essentiality of lymph’ to plasma volume and protein restoration after haemorrhage is fully accepted by the good Professor and other teachers of traditional Starling physiology. “Conservation of intravenous albumin … appears to be of such a magnitude as to be a major component in the plasma albumin refilling seen after experimental hemorrhage.”






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