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Books > Medicine > Other branches of medicine > Accident & emergency medicine > Intensive care medicine
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Fluid Physiology - A Handbook for Anaesthesia and Critical Care Practice (Hardcover, Unabridged edition)
Loot Price: R2,214
Discovery Miles 22 140
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Fluid Physiology - A Handbook for Anaesthesia and Critical Care Practice (Hardcover, Unabridged edition)
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This book is essential reading for medical or veterinary
practitioners who need to understand the new fluid physiology and
to apply it to the safe care of patients. The Starling principle is
one of medicine's most important concepts and originates from
Ernest Starling's laboratory research 120 years ago. However,
inappropriate fluid therapy is now recognised as harming and even
killing thousands of patients every year. In 2004, a landmark study
was published which confirmed the hypotheses put forward by Sheldon
Weinbaum and Charles Michel, among other physiologists, that, in
most tissues and in most situations, capillaries filter fluid to
the interstitium, but do not reabsorb it. This book draws together
for the first time the evolving science of the steady-state
Starling principle and the clinical evidence that reveals its
applicability to safer patient care. It is a thorough re-appraisal
of the basics of fluid therapy. The mantra of colloid boluses for
plasma volume resuscitation and colloid-free isotonic salt solution
for extracellular fluid volume does not explain observations from
blinded clinical trials, and the expectation of benefit for
resuscitation with colloids, particularly in respect of oedema, has
not materialised. Now that there is consensus that colloid volume
therapy should not be used in critically-ill patients, there is a
pressing need for a new paradigm for fluid therapy. This book
proposes an improved paradigm that takes into consideration the
Starling principle, which has been neglected by clinicians and
revised by physiologists in recent years. It retires the view of
colloids as preferred plasma substitutes, and focuses instead on
the central volume of distribution of an infused fluid, its rate of
distribution to a peripheral volume, and its rate of excretion. In
short, it emphasises volume kinetics.
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