Abstract
Objective: To demonstrate the TUR syndrome characterized with
hyponatraemia (HN) will no longer be seen after using saline
as irrigating fluid in urology, but it has re-incarnated as the acute
respiratory distress syndrome (ARDS) presenting with the same
clinical picture of the multiple organ dysfunction syndrome (MODS).
Material and Methods: A focused objective and relevant narrative review of other eminent authors’ work and mine are used
here.
Results: The TUR syndrome characterized with HN will no longer
occur in urology after the use of saline as irrigating fluid
in endoscopic surgery. It has reincarnated as ARDS presenting with the
same MODS clinical picture. It is induced by VO caused
by iv fluid infusions. This induces cardiovascular shock (VOS) that
cause ARDS. The latter is already common in clinical practice
due to the excessive us of iv fluids in the management of shock, acutely
ill patients, and prolonged major surgery as iatrogenic
complication of fluid therapy. The wrong Starling’s law dictates the
current faulty rules on fluid management of shock that mislead
physicians into giving too much fluid. The correct replacement is the
hydrodynamics of the porous orifice (G) tube which should be
the new scientific basis for fluid therapy in shock management. The
currently available hypertonic sodium therapy of 5%NaCl and/
or 8.4%NaCo3 is lifesaving therapy for HN, the TUR syndrome and ARDS.
Conclusion: The TUR syndrome may seem to have been eradicated in
urology with the use of saline as irrigating fluid in
endoscopic surgery. However, it has reincarnated as ARDS with the same
clinical picture of MODS. It is an iatrogenic complication of
fluid therapy dictated by the wrong Starling’s law for which the
hydrodynamic of the G tube is the correct replacement that should
be the new scientific basis for a new policy on fluid management of
shock.
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