Timeline for Can a colloid intravascular volume expander be used in chronic orthostatic hypotension?
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| Mar 29, 2018 at 23:16 | comment | added | Graham Chiu | Anyway, the point is that there is no evidence and theories without data can't be answered. | |
| Mar 29, 2018 at 23:14 | comment | added | Graham Chiu | researchgate.net/publication/… | |
| Mar 29, 2018 at 21:20 | comment | added | Josh | It looks to me like you're assuming: "Since condition X and condition Y have similar symptoms, and treatment A doesn't work for condition X, it probably won't work for condition Y either." That argument can fail when the underlying cause of the observed symptoms is different for conditions X and Y. | |
| Mar 29, 2018 at 21:10 | comment | added | Josh | Also: EDS-associated POTS may be very different than neurogenic hypotension, despite similar presentation. If the nervous system is "setting" the blood pressure too low, trying to fight it by boosting volume with fluids is likely to fail - the system can compensate by relaxing the arterial walls. But with EDS, the problem is likely caused by the arteries being too elastic to constrict as much as necessary. It is reasonable to expect increased volume to work in the latter case even if it fails in the former. I can confirm that a normal saline infusion did temporarily increase blood pressure. | |
| Mar 29, 2018 at 21:02 | comment | added | Josh | Thanks for the response. As for "colloids have never been shown to be better than crystalloids" - I address this point in my question. You are correct that it has been repeatedly demonstrated to be no more effective for treatment of acute hypovolemia, or (as you point out) for preventing lactic acidosis. That research may not apply at all to the issue at hand, though - it certainly has nothing to do with my proposed mechanism of action. | |
| Mar 29, 2018 at 20:11 | history | answered | Graham Chiu | CC BY-SA 3.0 |