The complete evidence that Starling's law for the capillary-interstitial fluid transfer is wrong: The correct replacement is the hydrodynamic of the porous orifice (G) tube


Ahmed N. Ghanem1 and Khaled A. Ghanem2

Introduction and objective To report hydrodynamic of a porous orifice (G) tube as replacement for the wrong Starling�??s law. Material and methods Hydrodynamics of the G tube, based on capillary ultra-structure, were studied, and contrasted to Poiseuille�??s tube. The effect of changing G tube orifice diameter, proximal pressure and distal pressure on the side pressure and chamber (C) pressure were evaluated. The physiological proof that the capillary works as G tube not Poiseuille�??s tube is provided. Results Hydrodynamics of the G tube showed that proximal, akin to arterial, pressure induces a negative side pressure gradient on the G tube wall, which is negative causing suction maximum near the inlet and turn positive near the exit causing filtration. This created the rapid, autonomous magnetic field-like fluid circulation phenomenon between G and C. The physiological evidence on the hind limb of sheep proves that the capillary works as G tube. Conclusion Hydrodynamic of the G tube challenges the role attributed to arterial pressure as a filtration force in Starling�??s law. A literature review shows that oncotic pressure does not work, and the law has failed to explain the capillary�??ISF transfer. A concept based on the new hydrodynamic phenomenon of the G tube is proposed to replace Starling�??s law. A rapid autonomous dynamic magnetic field-like G�??C circulation occurs. Factors which initiate, regulate, and affect G�??C circulation, its physiological proof and relevance to clinical importance are given. A physiological evidence on capillary working as G tube not Poiseuille�??s tube is provided.


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