Starling’s law on capillary-interstitial fluid transfer is wrong, what replacement is there? The hydrodynamic phenomenon of the porous orifice (G) tube

Introduction and objective: To report the hydrodynamic of a porous orifice (G) tube as replacement for the wrong Starling' law Material and method: Hydrodynamics of the G tube, based on capillary ultrastructure, were studied.The effect of changing G tube orifice diameter, proximal pressure and distal pressure on the side pressure and C pressure were evaluated.The literature on capillary physiology was reviewed.Result: 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 maximum near the exit causing filtration.This created the rapid, autonomous magnetic field like fluid circulation phenomenon between G and C. Conclusion:Hydrodynamic studies of the G tube challenge the role attributed to arterial pressure as a filtration force in Starling's law.A perspective literature review shows that the oncotic pressure force has been previously cancelled and the law has failed to explain the capillary-ISF transfer in most parts of the body.A concept based on the new hydrodynamic phenomenon of the G tube is proposed to replace Starling's law for the capillary-ISF circulation.A rapid autonomous dynamic magnetic field-like G-C circulation occurs between fluid in the G tube's lumen and a surrounding fluid compartment C. Factors which initiate, regulate and affect the G-C circulation, its physiological and haemodynamic relevance and its clinical importance to the pathogenesis of oedema, shock and the MVOD/F syndrome are discussed.