Magnetic field-like fluid circulation of a porous orifice tube and its relevance to the capillary–interstitial fluid circulation: preliminary report

Ghanem, Ahmed N

doi:10.1054/mehy.2000.1149

Cited by 31 publications

(77 citation statements)

References 10 publications

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“…In 1984, clinical observations inconsistent with Starling's hypothesis prompted =physical and clinical studies [10][11][12] to verify LP and fluid dynamics in a porous orifice (G) tube with reference to the effect of the pre-capillary sphincter, arterial and venous pressures on the capillary-ISF transfer. The observation was: during hypotension shock in which prompt and adequate vascular expansion for resuscitation, all fluids leaked into and drowned the ISF space and filled the potential body cavities, demonstrated on post-mortem examination!…”

Section: Introductionmentioning

confidence: 99%

The proof and reasons that Starling’s law for the capillary-interstitial fluid transfer is wrong, advancing the hydrodynamics of a porous orifice (G) tube as the real mechanism

Ghanem¹,

Ghanem²

2017

Blood Heart Circ

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Introduction and objective: In 1886, Starling proposed a hypothesis for the capillary-interstitial fluid (ISF) transfer, in which the capillary was thought a tube of a uniform diameter that is impermeable to plasma proteins. The flow of fluid across its wall was thought dependent upon a balance between the hydrostatic pressure within its lumen causing 'filtration', and the osmotic pressure of plasma proteins causing 'absorption'. The physical basis on which LP of a capillary was thought positive and responsible for filtration was Poiseuille's work on long Brass tubes of uniform diameters. Later discoveries demonstrated that the capillary is a porous orifice tube with totally different hydrodynamics that is reported here. Material and methods:The hydrodynamics of an inlet tube was studied in order to demonstrate the negative side pressure (SP) gradient exerted on its wall. We then studied the porous orifice (G) tube akin to capillary and later enclosed it in a chamber (C), akin to interstitial fluid space, making the G-C apparatus demonstrating the G-C circulation phenomenon. The effect of proximal (arterial) pressure (PP), distal (venous) pressure (DP) and inlet diameter on the SP and CP of the G-C model are reported. Result:The PP induces the negative SP in the G tube which is responsible for absorption. The orifice has an inverted bell shaped effect on SP and CP. The DP augments filtration. The G tube enclosed it in a chamber (C), making the G-C apparatus demonstrating the G-C circulation phenomenon. Conclusion:Hydrodynamic studies on G tube, based on capillary ultrastructure, demonstrate results which differ from Poiseuille's in a strait tube, challenge the role attributed to arterial pressure as a filtration force in Starling's hypothesis. A perspective literature review shows that the oncotic pressure force has been previously cancelled and the Starling's hypothesis has failed to explain the capillary-ISF transfer in most parts of the body.A concept based on a new hydrodynamic of the G-C model phenomenon is proposed for the capillary-ISF circulation. An autonomous dynamic magnetic field-like G-C circulation occurs between fluid in the G tube's lumen and a surrounding fluid compartment C. Based on results of studies on a circulatory model incorporating the G-C apparatus, factors which initiate, regulate and affect the G-C circulation, its physiological and haemodynamic relevance and its clinical importance to the pathogenesis of oedema and shock are discussed.

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Section: Introductionmentioning

confidence: 99%

The proof and reasons that Starling’s law for the capillary-interstitial fluid transfer is wrong, advancing the hydrodynamics of a porous orifice (G) tube as the real mechanism

Ghanem¹,

Ghanem²

2017

Blood Heart Circ

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“…He confirmed the effectiveness of hypertonic 5% NaCl or 8.4% Sodium Bicarbonate both as anecdotal evidence [42] and in a prospective study [1,2] and also investigated the underlying faulty physiological law of Starling for the capillary interstitial fluid transfer [43,44]. The results of a career life investigation which aimed at quantifying volumetric gain and its relation to the TURP syndrome highlighting VOS are now reported.…”

Section: Introductionmentioning

confidence: 70%

“…The fact that the capillary is encircled at the inlet by the pre-capillary sphincter inspired the suggestion that it may induce a Venturi effect. Further studies have revealed the totally different roles of the arterial and venous pressures in regulating simulated capillaryinterstitial fluid transfer [43,44]. In the light of these new findings, future studies are justified in order to explore the effects of volumetric overload on vascular pressures and tissue perfusion, as this may prove relevant to the pathogenesis of multiple organ failure and the adult respiratory distress syndrome.…”

Section: Discussionmentioning

confidence: 99%

Volumetric overload shocks in the patho-aetiology of the Transurethral Resection of the Prostate (Turp) Syndrome and acute dilution hyponatraemia: The clinical evidence based on prospective clinical study of 100 consecutive Turp patients

Ghanem¹,

Ghanem²,

Ghanem³

2017

Biomed Res Clin Prac

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“…Ghanem et al introduced the concept of volumetric overload in the patho-etiology of TURS in 1990 [1]. Ghanem confirmed the effectiveness of hypertonic 5%NaCl or 8.4% Sodium Bicarbonate both as anecdotal evidence [29] and in a prospective study [1] and also investigated the underlying faulty physiological law of Starling for the capillary interstitial fluid transfer [30,31].…”

Section: Literature Reviewmentioning

confidence: 98%

“…The hydrodynamics of the G tube demonstrated that the proximal (arterial) pressure induces a negative side pressure gradient on the wall of the G tube causing inflow suction (absorption) most prominent over the proximal half ( Figure 1) and turns into positive pressure over the distal half causing fluid outflow (filtration) [30,31] (Figure 2). Incorporating the G tube in a chamber (C) ( Figure 3,4), representing the interstitial space surrounding a capillary, demonstrated a rapid dynamic magnetic field-like fluid circulation between the C and G tube lumen ( Figure 5,6).…”

Section: Introductionmentioning

confidence: 99%

Volumetric overload shocks in the patho-etiology of the transurethral resection prostatectomy syndrome and acute dilution hyponatraemia

Pindoria¹,

Ghanem²,

Ghanem³

et al. 2017

Integr Mol Med

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The transurethral prostatectomy syndrome (TURS) is defined as severe vascular hypotension reaction that complicates endoscopic surgery as a result of massive irrigating fluid absorption causing severe acute dilution hyponatraemia (HN) of <120 mmol/l. The vascular shock is usually mistaken for one of the recognized shocks and Volumetric Overload Shock type 1 (VOS1) is overlooked making Volumetric Overload Shock Type 2 (VOS2) unrecognizable. VOS1 is induced by the infusion of 3.5-5 liters of sodium-free fluids and is known as TURS or HN shock. VOS2 is induced by 12-14 liters of sodium-based fluids and is known as the adult respiratory distress syndrome. The most effective treatment for VOS1 and VOS2 is hypertonic sodium of 5% NaCl or 8.4% Sodium Bicarbonate. The literature is reviewed and the underlying patho-etiology is discussed. As Starling's law for the capillary-interstitial fluid transfer proved wrong an alternative mechanism was found by studying the hydrodynamics of the porous orifice (G) tube. Incorporating the G tube in a chamber (C), representing the interstitial space surrounding a capillary, demonstrated a rapid dynamic magnetic field-like fluid circulation between the C and G tube lumen. The G-C phenomenon is autonomous having both filtration and absorption forces making a true replacement for Starling's law.

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Magnetic field-like fluid circulation of a porous orifice tube and its relevance to the capillary–interstitial fluid circulation: preliminary report

Cited by 31 publications

References 10 publications

The proof and reasons that Starling’s law for the capillary-interstitial fluid transfer is wrong, advancing the hydrodynamics of a porous orifice (G) tube as the real mechanism

The proof and reasons that Starling’s law for the capillary-interstitial fluid transfer is wrong, advancing the hydrodynamics of a porous orifice (G) tube as the real mechanism

Volumetric overload shocks in the patho-aetiology of the Transurethral Resection of the Prostate (Turp) Syndrome and acute dilution hyponatraemia: The clinical evidence based on prospective clinical study of 100 consecutive Turp patients

Volumetric overload shocks in the patho-etiology of the transurethral resection prostatectomy syndrome and acute dilution hyponatraemia

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