Acta Scientific Gastrointestinal Disorders (ISSN: 2582-1091)

Editorial Volume 3 Issue 5

Hepatic and Gastro-Intestinal Manifestations of Volumetric Overload Shocks (VOS) Causing ARDS

Ahmed N Ghanem*

Retired Consultant Urologist Surgeon, Faculty of Medicine, Mansoura University, Egypt

*Corresponding Author: Ahmed N Ghanem, Retired Consultant Urologist Surgeon, Faculty of Medicine, Mansoura University, Egypt.

Received: March 22, 2020; Published: April 01, 2020


  Substantial physics and physiological evidence with clinical relevance and significance currently exists that affirms Starling's law is wrong (Figure 1) [1-3]. Evidence that volumetric overload shocks (VOS) [4-7] cause the acute respiratory distress syndrome (ARDS) is also available [8]. These VOS are complications of fluid therapy in surgical patients due to many errors and misconceptions on fluid therapy [8] that mislead physicians into giving too much fluids during the resuscitation of shock and prolonged major surgery [9]. The clinical manifestations of VOS causing ARDS is shown in table 1, among the multiple system and vital organ dysfunctions are the hepatic and gastro-intestinal (GIT) manifestations [10-14]. These include hepatic dysfunction with elevated bilirubin, alkaline phosphates and liver enzymes of SGOT [10,11] and delayed recovery of intestinal function or paralytic ileus with nausea and vomiting [12,13].



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  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 Circulation 1 (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 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.
  5. Pindoria N., et al. “Volumetric overload shocks in the patho-etiology of the transurethral resection prostatectomy syndrome and acute dilution hyponatraemia”. Integrative Molecular Medicine (2017): 1000279.
  6. 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).
  7. 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 Journal 1 (2017): 1-7.
  8. Ghanem AN. “The Adult Respiratory Distress Syndrome: Volumetric Overload Shocks in Patho-Etiology Correcting Errors and Misconceptions on Fluid Therapy, Vascular and Capillary Physiology”. Surgical Medicine Open Access Journal 2 (2018): 000534.
  9. Ghanem AN. “What are 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).
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  39. Ghanem AN. “Complication of Fluid Therapy Causing the Acute Respiratory Distress Syndrome: Facts and Comments. The Role of Volumetric Overload Shocks in Patho-aetiology”. Archives of Urology1 (2019): 21-31.
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  42. 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.
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Citation: Ahmed N Ghanem. “Hepatic and Gastro-Intestinal Manifestations of Volumetric Overload Shocks (VOS) Causing ARDS”. Acta Scientific Gastrointestinal Disorders 3.5 (2020): 01-05.


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