Fluid Therapy (FT) Complications: Volumetric Overload (VO) in the patho-Aetiology of VO Shocks (VOS) and the Acute Respiratory Distress Syndrome (ARDS)

Abstract

Fluid therapy (FT) was introduced during WW2. Ever since its complications have been frequently reported but notably some serious complications have been overlooked. The role of volumetric overload (VO) in inducing VU shocks (VOS) and causing the acute respiratory distress syndrome (ARDS) has remained overlooked, unrecognized, and underestimated till recently. The role of FT complications in inducing VOS and causing ARDS is hard to detect because VOS is a shock that complicates another existing shock seamlessly and un-noticed. The author attributes this to the faulty rules on FT dictated by the wrong Starling’s law that causes many errors and misconceptions of FT which mislead physicians into giving too much fluid during shock resuscitation. The research findings on the wrong Starling’s law and how it has been corrected based on the hydrodynamic of the porous orifice (G) tube and the newly recognized VOS and the new patho-aetiology and therapy of ARDS are summarized here. Other authors in support of this contention are quoted. The errors on current FT and its corrections are given. Finally, a new prospective cohort study on FT and ARDS is recommended and a call for new guidelines on FT is urgently needed.