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mathematical model resuscitation trauma

Jamal Siam, Marwa Kadan, Ron Flaishon, Ofer Barnea
The effectiveness of fluid resuscitation regimens in hemorrhagic trauma is assessed based on its ability to increase oxygen concentration in tissue. Fluid resuscitation using both crystalloids and colloids fluids, creates a dilemma due to its opposing effects on oxygen transfer. It increases blood flow thereby augmenting oxygen transport but it also dilutes the blood simultaneously and reduces oxygen concentration thereby reducing oxygen transport. In this work we have studied these two opposing effects of fluid therapy on oxygen delivery to tissue...
December 2015: Cardiovascular Engineering and Technology
Stephanie A Savage, Ben L Zarzaur, Martin A Croce, Timothy C Fabian
BACKGROUND: The practice of 1:1 transfusion, administering packed red blood cells (PRBCs) with fresh frozen plasma (FFP), has been associated with improved survival. However, the reported ratios are the result of mathematical averages over 24 hours and do not necessarily represent concurrent administration. Using critical administration thresholds (CAT+) of more than 3 U of PRBC per hour to identify hemorrhaging patients, this study evaluates the effect of concurrent administration of PRBC/FFP on patient survival...
December 2014: Journal of Trauma and Acute Care Surgery
Robert D Combes
Military research, testing, and surgical and resuscitation training, are aimed at mitigating the consequences of warfare and terrorism to armed forces and civilians. Traumatisation and tissue damage due to explosions, and acute loss of blood due to haemorrhage, remain crucial, potentially preventable, causes of battlefield casualties and mortalities. There is also the additional threat from inhalation of chemical and aerosolised biological weapons. The use of anaesthetised animal models, and their respective replacement alternatives, for military purposes -- particularly for blast injury, haemorrhaging and resuscitation training -- is critically reviewed...
November 2013: Alternatives to Laboratory Animals: ATLA
Marc Maegele, Philip C Spinella, Herbert Schöchl
Trauma remains the leading cause of death, with bleeding as the primary cause of preventable mortality. When death occurs, it happens quickly, typically within the first 6 h after injury. The principal drivers of the acute coagulopathy of trauma have been characterized, but another group of patients with early evidence of coagulopathy both physiologically and mechanistically distinct from this systemic acquired coagulopathy has been identified. This distinct phenotype is present in 25% to 30% of patients with major trauma without being exposed to the traditional triggers and is associated with higher morbidity and a 4-fold increase in mortality...
November 2012: Shock
Claudio E Lagoa, John Bartels, Arie Baratt, George Tseng, Gilles Clermont, Mitchell P Fink, Timothy R Billiar, Yoram Vodovotz
Trauma and hemorrhagic shock (HS) elicit severe physiological disturbances that predispose the victims to subsequent organ dysfunction and death. The general lack of effective therapeutic options for these patients is mainly due to the complex interplay of interacting inflammatory and physiological elements working at multiple levels. Systems biology has emerged as a new paradigm that allows the study of large portions of physiological networks simultaneously. Seeking a better understanding of the interplay among known inflammatory pathways, we constructed a mathematical model encompassing the dynamics of the acute inflammatory response that incorporates the intertwined effects of inflammation and global tissue damage...
December 2006: Shock
Kevin Jun-Qiang Lu, Li-Chien Chien, Charles C J Wo, Demetrios Demetriades, William C Shoemaker
BACKGROUND: The aims of this prospective observational study were to describe early hemodynamic patterns of blunt and penetrating truncal injury and to evaluate outcomes prediction using noninvasive hemodynamic monitoring with a mathematical model tested against actual in-hospital outcomes. The hypothesis was that traumatic shock is a circulatory disorder that can be monitored by noninvasive hemodynamic parameters that reflect cardiac, pulmonary, and tissue perfusion functions. STUDY DESIGN: The cardiac index (CI), heart rate (HR), mean arterial pressure (MAP), pulse oximetry (SapO(2)), transcutaneous oxygen tension indexed to FiO(2) (PtcO(2)/FiO(2)), and carbon dioxide (PtcCO(2)) tensions were monitored beginning shortly after emergency department admission in 657 emergency patients with severe blunt and penetrating chest, abdominal, and extremity trauma...
December 2006: Journal of the American College of Surgeons
Jose M Prince, Ryan M Levy, John Bartels, Arie Baratt, John M Kane, Claudio Lagoa, Jonathan Rubin, Judy Day, Joyce Wei, Mitchell P Fink, Sanna M Goyert, Gilles Clermont, Timothy R Billiar, Yoram Vodovotz
The inflammatory phenotype of genetically modified mice is complex, and the role of Gram-negative lipopolysaccharide (LPS) in acute inflammation induced by surgical cannulation trauma, alone or in combination with hemorrhage and resuscitation ("hemorrhagic shock"), is both complex and controversial. We sought to determine if a mathematical model of acute inflammation could elucidate both the phenotype of CD14-deficient (CD14(-/-)) mice--following LPS, cannulation, or hemorrhagic shock--and the role of LPS in trauma/hemorrhage-induced inflammation...
April 2006: Molecular Medicine
William C Shoemaker, Charles C J Wo, Kevin Lu, Li-Chien Chien, David S Bayard, Howard Belzberg, Demetrios Demetriades, Roger W Jelliffe
BACKGROUND: The aims are to apply a mathematical search and display model based on noninvasive hemodynamic monitoring, to predict outcome early in a consecutively monitored series of 661 severely injured patients. METHODS: A prospective observational study by a previously designed protocol in a Level I trauma service in a university-run inner city public hospital was conducted. The survival probabilities were calculated at the initial resuscitation on admission and at subsequent intervals during their hospitalization beginning shortly after admission to the emergency department...
January 2006: Journal of Trauma
Anthony M H Ho, Peter W Dion, Claudia A Y Cheng, Manoj K Karmakar, Gregory Cheng, Zhiyong Peng, Yu Wai Ng
BACKGROUND: Randomized controlled trials of how best to administer fresh frozen plasma (FFP) in the presence of ongoing severe traumatic hemorrhage are difficult to execute and have not been published. Meanwhile, coagulopathy remains a common occurrence during major trauma resuscitation and hemorrhage remains a major cause of traumatic deaths, suggesting that current coagulation factor replacement practices may be inadequate. METHODS: We used a pharmacokinetic model to simulate the dilutional component of coagulopathy during hemorrhage and compared different FFP transfusion strategies for the prevention or correction, or both, of dilutional coagulopathy...
December 2005: Canadian Journal of Surgery. Journal Canadien de Chirurgie
William C Shoemaker, David S Bayard, Charles C J Wo, Linda S Chan, Li-Chien Chien, Kevin Lu, Roger W Jelliffe
OBJECTIVE: This study applies a stochastic or probability search and display model to prospectively predict outcome and to evaluate therapeutic effects in a consecutively monitored series of 396 patients with severe thoracic and thoracoabdominal injuries. STUDY DESIGN: Prospective observational study of outcome prediction using noninvasive hemodynamic monitoring by previously designed protocols and tested against actual outcome at hospital discharge in a level 1 trauma service of a university-run, inner-city public hospital...
October 2005: Chest
William C Shoemaker, David S Bayard, Andreas Botnen, Charles C J Wo, Ashutosh Gandhi, Li-Chien Chien, Kevin Lu, Matthew J Martin, Linda S Chan, Demetrios Demetriades, Nasrollah Ahmadpour, Roger W Jelliffe
OBJECTIVES: The aims were a) to noninvasively monitor acute emergency trauma patients beginning within 1 hr after admission to the emergency department; b) to prospectively predict outcome; and c) to evaluate the relative effectiveness of various modes of therapy. DESIGN: Prospective outcome prediction study using a mathematical search and display model based on noninvasive hemodynamic monitoring. SETTING: A level I trauma service in a large university-run inner-city public hospital...
July 2005: Critical Care Medicine
A Hedlund, B Zaar, T Groth, G Arturson
Computer-based 'patient simulators' are of a potential value in diagnosis, monitoring and therapy of the severely ill patient with trauma. An extensive pathophysiological model is described and documented in full detail. The model makes it possible to calculate and predict clinically important state variables on the basis of fluid input and fluid losses. Sample runs are presented for illustrations in hemorrhage, fluid and salt loading.
July 1988: Computer Methods and Programs in Biomedicine
M C Mazzoni, P Borgstrom, K E Arfors, M Intaglietta
Rapid blood volume expansion is the goal in prehospital hemorrhage resuscitation. A comparison was made for fixed volume and uncontrolled hemorrhage between three fluid regimes: Ringer's lactate (RL), Macrodex (MD), or a small volume of a hyperosmotic solution (HSD, 7.5% NaCl/6% dextran 70) followed by RL. A mathematical model was developed to simulate blood volume restoration for these given hemorrhage and resuscitation situations. Model predictions for a fixed hemorrhage (35%) and reinfusion of each fluid regime (1 mL...
April 1990: Annals of Emergency Medicine
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