Abstract

Introduction and objective: To report critical literature analysis that shows volumetric overload shock (VOS) is the real patho-etiology of the adult respiratory distress syndrome (ARDS) demonstrating multiple errors and misconceptions on fluid therapy that predisposes to VOS and ARDS.

Material and methods: The literature on ARDS and physiological law of starling is critically analyzed revealing the multiple errors and misconceptions prevailing in fluid therapy. Recent reports on VOS in the patho-etiology of ARDS are summarized.

Result: The literature on ARDS and physiological law of starling is critically analyzed revealing multiple errors and misconceptions. Starling’s law is wrong as both of its forces do not work as proposed. Errors have been corrected and the hydrodynamics of porous orifice G tube are advanced as replacement for Starling’s law. The evidence confirmed VOS induced by sodium-based fluids is the real patho-etiology of ARDS.

Conclusion: The critical literature analysis on ARDS and physiological law of Starling rectified many errors and misconceptions. The hydrodynamics of the G tube in a surrounding chamber C that mimics capillary-interstitial compartment shows a magnetic fluid shaped phenomenon that gives a real replacement for Starling’s law for the capillary-interstitial fluid transfer. The VOS proved to be the real patho-etiology of ARDS.

Keywords: Shock; ARDS; Volumetric overload shocks; Starling’s law; capillary-interstitial fluid transfer

Abbreviations: ARDS: The Adult Respiratory Distress Syndrome; MVOD/F: Multiple Vital Organ Dysfunction/Failure Syndrome; VO: Volumetric Overload; VOS: Volumetric Overload Shock; VOS1: Volumetric Overload Shock Type 1; VOS2: Volumetric Overload Shock Type 2; CVP: Central Venous Pressure; BP: Arterial Blood Pressure; BW: Body Weight; CVS: Cardiovascular System; ISF: Interstitial Fluid; HST: Hypertonic Sodium Therapy; G Tube: Porous Orifice Tube; C: Chamber Around the G Tube; G-C Circulation: The Circulation Phenomenon between the G Tube and the Surrounding Chamber; PP: Proximal Pressure; DP: Distal Pressure; LP: Lumen Dynamic Pressures Inside a Tube; FP: Flow Pressure Component of LP; SP: Side Pressure Component of LP