Скачать или смотреть Tutorial 10: The Microcirculation and Capillaries

This tutorial reviews the concept of the “Starling Principle” and the Starling equation and why it is hugely problematic. To understand the modern concept of the microcirculation you need to accept that, in the 21st century – our concept of the architecture of capillaries and the microcirculation has evolved considerably. I am going to introduce the capillary glycocalyx and the "Revised Starling Concept." This changes the way we think about intravenous fluid therapy going forward.
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0:00 Beginning and Introduction
01:14 Contents
01:50 Clinical Scenario (Sepsis)
02:15 Capillary Refill Time
03:45 The Capillary Network
05:40 Control of Flow Through the Capillaries
07:30 Erythrocytes and Capillaries
08:20 Traditional Starling Model
11:00 Albumin and Oncotic Pressure in the Starling Model
13:00 The Starling Equation
14:00 The Staverman Reflection Co-Efficient
15:40 Why the Starling Model is Wrong
16:25 The Glycocalyx
19:50 The True Hydrostatic Pressure Gradient
21:20 The Real Oncotic Pressure Gradient
23:10 The Revised Starling Equation
25:10 Pericapillary Albumin Transport
27:00 Tissue Compliance - normal and low volume
28:30 What Happens to Extravascated Fluid? How Much, How Little?
30:30 Impact of Inflammation on Fluid Extravascation
32:50 The Lymphatic System
36:40 Review