Editorial
Volume 5 Issue 3 - 2021
Cardiovascular and Hematological Manifestations of the Acute Respiratory Distress Syndrome (ARDS) Caused by the Newly Discovered Volumetric Overload Shocks (VOS). Is it Relevant to Covid-19 Pandemic ARDS?
Ahmed N Ghanem*
Retired Consultant Urologist Surgeon and Independent Investigator, Faculty of Medicine, Mansoura University, Mansoura, Egypt
*Corresponding Author: Ahmed N Ghanem, Retired Consultant Urologist Surgeon and Independent Investigator, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Received: February 02, 2021; Published: February 24, 2021




Keywords: Cardiovascular Manifestation; Hematological Manifestation; ARDS; Shock; Volume Overload; Covid-19

Abbreviations

VOS: Volumetric Overload Shocks; ARDS: The Acute Respiratory Distress Syndrome; MODS: The Multiple Organ Dysfunction Syndromes; CVS: Cardiovascular System; VO: Volumetric Overload; L: Liter

Substantial physics and physiological evidence with clinical relevance and significance currently exists that affirm Starling's law wrong (Figure 1) [1-4], particularly now as the definitive affirmative proof is being reported [5]. Evidence that volumetric overload shocks (VOS) [6-9] cause the acute respiratory distress syndrome (ARDS) is also available [10,11]. These VOS are complications of fluid therapy in hospital practice, particularly in surgical patients due to many errors and misconceptions on fluid therapy [12] that mislead physicians into giving too much fluid during the resuscitation of shock, acutely ill patients, and prolonged major surgery [13]. The clinical manifestations of VOS causing ARDS is that of the multiple organ dysfunction syndromes (MODS) shown in table 1, among it are the cardiovascular system (CVS)and hematological manifestations of ARDS [14-16]. These include cardiac dysrhythmia particularly and characteristically bradycardia with signs of shock prevailing. This shock is always mistaken for one of the recognized shocks of septic or haemorrhagic and treated wrongly with further volume expansion using colloids/crystalloids and/or blood transfusion!

References

    1. Ghanem AN. “Magnetic field-like fluid circulation of a porous orifice tube and relevance to the capillary-interstitial fluid circulation: Preliminary report”. Medical Hypotheses3 (2001): 325-334.
    2. Ghanem KA and Ghanem AN. “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”. Blood, Heart and Circulation1 (2017): 1-7.
    3. Ghanem KA and Ghanem AN. “The Physiological Proof that Starling’s Law for the Capillary-Interstitial Fluid Transfer is wrong: Advancing the Porous Orifice (G) Tube Phenomenon as Replacement”. Open Access Research in Anatomy2 (2017): OARA.000508.
    4. Ghanem AN. “The Correct Replacement for the Wrong Starling’s law is the Hydrodynamic of the Porous Orifice (G) Tube: The Complete Physics and physiological Evidence with Clinical Relevance and Significance”. Cardiology: Open Access Cardio Open1 (2020): 7.
    5. Ghanem AN. “Final affirmative proof Starling’s law wrong and G tube correct replacement: New results and critical analytical criticisms of landmark articles”.
    6. Ghanem AN and Ghanem SA. “Volumetric Overload Shocks: Why Is Starling’s Law for Capillary Interstitial Fluid Transfer Wrong? The Hydrodynamics of a Porous Orifice Tube as Alternative”. Surgical Science6 (2016): 245-249.
    7. Pindoria N., et al. “Volumetric overload shocks in the patho-aetiology of the transurethral resection prostatectomy syndrome and acute dilution hyponatraemia”. Integrative Molecular Medicine (2017): 1000279.
    8. Ghanem KA and Ghanem AN. “Volumetric overload shocks in the patho-etiology of the transurethral resection prostatectomy syndrome and acute dilution hyponatraemia: The clinical evidence based on 23 case series”. Basic Research Journal of Medicine and Clinical Sciences4 (2017).
    9. Ghanem SA., et al. “Volumetric Overload Shocks in the Patho Etiology 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”. Surgical Medicine Open Access Journal1 (2017): 1-7.
    10. Ghanem AN. “Volumetric Overload Shocks Cause the Acute Respiratory Distress Syndrome: The Plenary Evidence on Patho-Aetiology and Therapy”. Open Access International Research Journal of Biological Sciences 4 (2020).
    11. Ghanem AN. “Volumetric Overload Shocks Cause the Acute Respiratory Distress Syndrome: Building the Bridge Between Physics, Physiology, Biochemistry, and Medicine”. Biomedical Journal of Scientific and Technical Research 1 (2020).
    12. Ghanem AN. “The Adult Respiratory Distress Syndrome: Volumetric Overload Shocks in Patho-Aetiology, Correcting Errors and Misconceptions on Fluid Therapy, Vascular and Capillary Physiology”. Surgical Medicine Open Access Journal 2 (2018).
    13. Ghanem AN. “What is Misleading Physicians into giving too much Fluid During Resuscitation of Shock and Surgery that Induces ARDS and/or AKI?” Asploro Journal of Biomedical and Clinical Case Reports (2020).
    14. Khadaroo Rachel G and John C Marshall. “ARDS and the multiple organ dysfunction syndrome: common mechanisms of a common systemic process”. Critical Care Clinics1 (2002): 127-141.
    15. Rowan KM., et al. “PRISM Investigators “Early, Goal-Directed Therapy for Septic Shock - A Patient-Level Meta-Analysis”. New England Journal of Medicine23 (2017): 2223-2234.
    16. Huang DT., et al. “Harmonizing international trials of early goal-directed resuscitation for severe sepsis and septic shock: methodology of ProCESS, ARISE, and ProMISe”. Intensive Care Medicine10 (2013): 1760-1775.
    17. Frater JL., et al. “COVID-19 and the clinical hematology laboratory”. International Journal of Laboratory Hematology 1 (2020): 11-18.
    18. Whyte CS., et al. “Fibrinolytic abnormalities in acute respiratory distress syndrome (ARDS) and versatility of thrombolytic drugs to treat COVID-19”. The Journal of Thrombosis and Haemostasis 18 (2020): 1548-1555.
    19. Gerges Harb J., et al. “SARS, MERS and COVID-19: clinical manifestations and organ-system complications: a mini review”. Pathogens and Disease 4 (2020): ftaa033.
    20. Zhang T., et al. “[Comparison of clinical and pathological features between severe acute respiratory syndrome and coronavirus disease 2019]”. Zhonghua Jie He He Hu Xi Za Zhi6 (2020): 496-502.
    21. Nandy S., et al. “Cardiovascular manifestations of COVID-19”. Current Cardiology Reviews (2020).
    22. Ghanem AN. “The Transurethral Prostatectomy (TURP) Syndrome: An Investigation of the Osmotic and Metabolic sequelae of Volumetric Overload (VO)”. MD Thesis. Institute of Urology and Nephrology, Mansoura University, Egypt (1988).
    23. Ghanem AN and Ward JP. “Osmotic and metabolic sequelae of volumetric overload in relation to the TURP syndrome”. British Journal of Urology1 (1990): 71-78.
    24. Ashbaugh DG., et al. “Acute respiratory distress in adults”. Lancet7511 (1967): 319-323.
    25. Hahn RG. “Adverse effects of crystalloid and colloid fluids”. Anaesthesiology Intensive Therapy4 (2017): 303-308.
    26. Jones DG., et al. “Crystalloid resuscitation in trauma patients: deleterious effect of 5L or more in the first 24h”. BMC Surgery1 (2018): 93.
    27. Coons BE., et al. “High volume crystalloid resuscitation adversely affects paediatric trauma patients”. Journal of Pediatric Surgery11 (2018): 2202-2208.
    28. Creevey CD. “Hemolytic reaction during transurethral prostatic resection”. The Journal of Urology 58 (1947): 125-131.
    29. Harrison III RH., et al. “Dilutional hyponatraemic shock: another concept of the transurethral prostatic reaction”. The Journal of Urology 75 (1956): 95-110.
    30. Danowski TS., et al. “The treatment of shock due to salt depression; comparison of isotonic, of hypertonic saline and of isotonic glucose solutions”. Journal of Clinical Investigation 25 (1946): 130-138.
    31. Arieff AI. “Hyponatraemia, convulsion, respiratory arrest and permanent brain damage after elective surgery in healthy women”. New England Journal of Medicine24 (1986): 1529-1534.
    32. Ghanem AN. “New Discoveries in Medicine and Physiology Originated in Urology”. Surgical Medicine Open Access Journal (2020).
    33. Ghanem AN. “Volumetric overload shocks or volume kinetic shocks in clinical practice. Resolving the puzzles of the transurethral resection of the prostate (TURP) syndrome, acute dilution hyponatraemia (HN) and the acute respiratory distress syndrome (ARDS)”. Book. Scholars Press USA. 2018 1st edition and 2021 2nd
    34. Ghanem AN. “Scientific Discoveries of the 21st century. Book. Scholars Press 2021 1st edition (2021).
    35. Ghanem AN. “The scientific basis of fluid therapy in shock: Based on new scientific discoveries in physics, physiology, and medicine”. Book. Eliva Press (2021).
    36. Ghanem AN. “Acute Respiratory Distress Syndrome (ARDS): Is it relevant to Covid-19 pandemic ARDS? The puzzle is resolved being recognized as an iatrogenic complication of fluid therapy that induce volumetric overload shocks (VOS) and cause ARDS”. Eliva Press (2021).
    37. Ghanem AN. “New scientific basis of fluid therapy in shock management: the complications. the complete evidence based on new scientific discoveries in physics, physiology, and medicine”. Austin Macauley Publishers Ltd®, London, New York, Cambridge, Sharjah. Comes in 36 Chapters and 516 pages (2021).
    38. Starling EH. “Factors involved in the causation of dropsy”. Lancet 2 (1886): 1266-1270.
    39. Folkow B and Neil E. “Circulation”. Oxford University Press: London (1971): 1-125.
    40. Keele CA., et al. “Sampson Wright Applied Physiology”. 13th Oxford University Press Oxford (1982).
    41. Rhodin JA. “The ultra-structure of mammalian arterioles and pre-capillary sphincters”. Journal of Ultrastructure Research 18 (1967): 181-222.
    42. Karnovesky MJ. “The ultra-structural basis of capillary permeability studied with peroxidase as a tracer”. Journal of Cell Biology 1 (1967): 213-236.
    43. Hendry EB. “The osmotic pressure and chemical composition of human body fluids”. Clinical Chemistry3 (1962): 246-265.
    44. Cochrane Injuries Group. “Human albumin administration in the critically ill patients: systemic review of randomized controlled trials: Why albumin may not work”. British Medical Journal7153 (1998): 235-240.
    45. Finfer S. “Effect of baseline serum albumin concentration on outcome of resuscitation with albumin or saline in patients in intensive care units: analysis of data from the saline versus albumin fluid evaluation (SAFE) study”. British Medical Journal7577 (2006): 1044-1046.
    46. Vincent JL. “Resuscitation using albumin in critically ill patients: Research in patients at high risk of complications is now needed”. British Medical Journal7577 (2006): 10291030.
    47. Futier E., et al. “Effect of Hydroxyethyl Starch vs Saline for Volume Replacement Therapy on Death or Postoperative Complications Among High-Risk Patients Undergoing Major Abdominal Surgery: The FLASH Randomized Clinical Trial”. Journal of the American Medical Association3 (2020): 225-236.
    48. Guyton AC and Coleman TG. “Regulation of interstitial fluid volume and pressure”. Annals New York Academy of Sciences3 (1968): 537-547.
    49. Calnan JS., et al. “Lymphatic surgery”. Proceedings of the Royal Society of Medicine 65 (1972): 715-719.
    50. Renkin EM. “Some consequences of capillary permeability to macromolecules: Starling’s hypothesis reconsidered”. American Journal of Physiology - Heart and Circulatory Physiology19 (1986): H706-H710.
    51. Rivers E., et al. “Early goal-directed therapy in the treatment of severe sepsis and septic shock”. New England Journal of Medicine19 (2001): 1368-1377.
    52. Rivers EP., et al. “Early interventions in severe sepsis and septic shock: a review of the evidence one decade later”. Minerva Anestesiologica 6 (2012): 712-724.
    53. Woodcock TE and Woodcock TM. “Revised Starling equation and the glycocalyx model of trans-vascular fluid exchange: an improved paradigm for prescribing intravenous fluid therapy”. British Journal of Anaesthesia 3 (2013): 384-394.
    54. Rodney Levick and C Charles Michel. “Microvascular fluid exchange and the revised Starling principle”. Cardiovascular Research 87 (2010): 198-210.
    55. Ghanem AN and Ghanem KA. “Revised Starling’s Principle (RSP): a misnomer as Starling’s law is proved wrong”. Medico Research Chronicles (2020).
    56. Bernstein SN., et al. “Case Records Of The Massachusetts General Hospital”. Case 33-2019: A 35-Year-Old Woman with Cardiopulmonary Arrest during Caesarean Section”. The New England Journal of Medicine 381 (2019): 1664-1673.
    57. Ghanem AN. “Cardiac arrest and volumetric overload shocks (VOS) complicating fluid therapy”. EC Clinical and Medical Case Reports (2019).
    58. Schrier RW. “Fluid administration in critically ill patients with acute kidney injury”. Clinical Journal of the American Society of Nephrology4 (2010): 733-739.
    59. Ghanem AN. “Preventing Renal Failure in the Critically Ill Patient: Identifying the Problems and Finding the Solutions”. EC Emergency Medicine and Critical Care6 (2019): 346-348.
    60. Ghanem AN. “Does Raising the Central Venous Pressure (CVP) in Treating Shock with Fluids Induce Volumetric Overload Shocks (VOS)?” Advance in Cardiac Research5 (2019): 000120.
    61. Ghanem AN. “Update on Ghanem’s new scientific discoveries in physics”. Physiology, and Medicine, Research in Infectious Diseases and Tropical Medicine1 (2020): 52-57.
    62. Ghanem AN. “Twenty-one reasons affirming Starling’s law on the capillary-interstitial fluid (ISF) transfer wrong and the correct replacement is the hydrodynamic of the porous orifice (G) tube”. Open Journal of Clinical Case Reports 1 (2020): 8-11.
    63. Ghanem AN. “Editorial. Goodbye Starling's law, hello G tube”. International Urology and Nephrology 1 (2020).
    64. Ghanem AN. “Impact of COVID-19 on Surgery and Anaesthesia: Fighting Another Unique War on ARDS Relevant to Covid-19 Pandemic”. EC Emergency Medicine and Critical Care2 (2021).
Citation: Ahmed N Ghanem. “Cardiovascular and Hematological Manifestations of the Acute Respiratory Distress Syndrome (ARDS) Caused by the Newly Discovered Volumetric Overload Shocks (VOS). Is it Relevant to Covid-19 Pandemic ARDS?”. EC Emergency Medicine and Critical Care 5.3 (2021): 01-10.

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