Explain the physiological processes involved in the development of tissue interstitial oedema.
The question required an accurate statement of Starling’s Equation, including the
filtration and reflection co-efficients, and definitions of terms. Marks were awarded
for numerical values pertaining to hydrostatic and oncotic pressure gradients and net
filtration in a 24 hour period.
A satisfactory answer explained the factors which cause imbalance in Starling’s
relationship including; precapillary vasodilation, increased venous pressures, gravity
/ posture, fall in plasma protein concentration, changes to capillary permeability and
Recommended sources: Review of Medical Physiology, Ganong, Chp 23 and other
Starling, Ernest Henry. "On the absorption of fluids from the connective tissue spaces." Classic Papers in Critical Care 19 (1896): 303.
Woodcock, T. E., and Thomas M. Woodcock. "Revised Starling equation and the glycocalyx model of transvascular fluid exchange: an improved paradigm for prescribing intravenous fluid therapy." British journal of anaesthesia 108.3 (2012): 384-394.
Erstad, Brian L. "The Revised Starling Equation: The Debate of Albumin Versus Crystalloids Continues." Annals of Pharmacotherapy (2020): 1060028020907084.
Krogh, August, E. M. Landis, and A. H. Turner. "The movement of fluid through the human capillary wall in relation to venous pressure and to the colloid osmotic pressure of the blood." The Journal of clinical investigation 11.1 (1932): 63-95.