Question: May cardiac arrest affect TURP patients?How may fluid resuscitation induce VOS and what is its link with the G tube?
Findings: Cardiac arrest occurs in TURP syndrome. Overzealous fluid infusion induces VOS1 and VOS2. VOS1 is induced by sodium-free fluids characterized with HN known as the TURP syndrome. VOS2 is induced with sodiumbased fluids presenting as ARDS. The wrong starling’s law caused errors misleading physicians into giving too much fluid. The correct replacement is the G tube hydrodynamic.
Meaning: Giving too much fluid during resuscitation of poly-trauma, shock and prolonged surgery induces the newly recognised VOS and causes ARDS. The faulty Starling’s low underlies the errors and misconceptions on fluid therapy. 5%NaCl is lifesaving.
Introduction and objective: To report that volumetric overload shock (VOS) type 1 (VOS1) known as TURP syndrome and type2 (VOS2) may complicate fluid resuscitation of poly-trauma causing the acute respiratory distress syndrome (ARDS).
Materials and Methods: Evidence from analytical review of literature and results of my research demonstrates fluid therapy may induce VOS and cause ARDS. Errors on fluid therapy, underlying it all the wrong law of Starling, may mislead physicians into giving too much fluids. I conducted and reported 2 clinical, 1 physics and 1 physiological studies that investigated these issues.
Result: Overzealous fluid infusion induces 2 types of VOS, VOS1 and VOS2. VOS1 is induced by sodium-free fluids characterized with hyponatraemia (HN). VOS1 is known as the transurethral resection of the prostate (TURP) syndrome. Hypertonic sodium is lifesaving treatment. VOS2 is induced with sodium-based fluids and has no markers.VOS2 presents as ARDS. Both have features of the multiple vital organ dysfunction/failure (MVOD/F) syndromes. Coma, ARDS and acute kidney injuryoccur in any combination but one system may predominate. The wrong starling’s law caused errors misleading physicians into giving too much fluid during resuscitation of shock and poly-trauma. The correct replacement is the hydrodynamic of the G tube.
Conclusion: Two new types of shocks are reported, VOS1 and VOS2. VOS1 is characterized with HN for which 5%NaCl is lifesaving treatment. Both present with MVOD/F syndromeor ARDS and induced by overzealous fluid infusion. The wrong Starling’s law dictates the faulty rules on fluid therapy. The correct replacement is the hydrodynamic of the G tube.