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mathematical model hemorrhage trauma

Cayley Bowles, Daniel Canuto, Joseph Teran, Erik Dutson, David Plurad, Jeff Eldredge, Peyman Benharash
As animal models fall out of favor, there is demand for simulators to train medical personnel in the management of trauma and hemorrhage. Realism is essential to the development of simulators for training in the management of trauma and hemorrhage, but is difficult to achieve because it is difficult to create models that accurately represent bleeding organs. We present a simulation platform that uses real-time mathematical modeling of hemodynamics after hemorrhage and trauma and visually represents the injury described by the model...
October 1, 2017: American Surgeon
Rachel Pardes Berger, Brian J Pak, Mariya D Kolesnikova, Janet Fromkin, Richard Saladino, Bruce E Herman, Mary Clyde Pierce, David Englert, Paul T Smith, Patrick M Kochanek
Importance: Abusive head trauma is the leading cause of death from physical abuse. Missing the diagnosis of abusive head trauma, particularly in its mild form, is common and contributes to increased morbidity and mortality. Serum biomarkers may have potential as quantitative point-of-care screening tools to alert physicians to the possibility of intracranial hemorrhage. Objective: To identify and validate a set of biomarkers that could be the basis of a multivariable model to identify intracranial hemorrhage in well-appearing infants using the Ziplex System...
June 5, 2017: JAMA Pediatrics
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
Rupert Faltermeier, Martin A Proescholdt, Sylvia Bele, Alexander Brawanski
Although multimodal monitoring sets the standard in daily practice of neurocritical care, problem-oriented analysis tools to interpret the huge amount of data are lacking. Recently a mathematical model was presented that simulates the cerebral perfusion and oxygen supply in case of a severe head trauma, predicting the appearance of distinct correlations between arterial blood pressure and intracranial pressure. In this study we present a set of mathematical tools that reliably detect the predicted correlations in data recorded at a neurocritical care unit...
2015: Computational and Mathematical Methods in Medicine
Makoto Yoshida, Junpei Yamazaki, Hiroshi Mizunuma
We aimed to elucidate the mechanism of the retinal hemorrhage (RH) accompanied by shaken baby syndrome or abusive head trauma (SBS/AHT) by analyses using a computational model. We focused on a hypothesis that the vitreoretinal traction due to acceleration and deceleration caused by abusive shaking leads to retinal hemorrhage. A finite element (FE) mechanical model with simple spherical geometry was constructed. When the FE mechanical model was virtually shaken, the intensity of the stress applied to the retinal plane agreed well with the results from an analysis using a physical model made of agar gel...
November 7, 2014: Journal of Biomechanics
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
Jonas P DeMuro, Susan Simmons, Judy Jax, Scott M Gianelli
INTRODUCTION: The traditional method to identify hemorrhage after trauma has been vital signs-based. More recent attempts have used mathematical prediction models, but these are limited by the need for additional data including a Focused Assessment with Sonography for Trauma exam, or an arterial blood gas. Shock Index (SI) is the mathematical relationship of the heart rate divided by the systolic blood pressure; the cutoff of >0.9 has been associated with bleeding. METHODS: A total of 4292 trauma patients were identified in database over an 11 year period...
August 2013: American Journal of Emergency Medicine
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
P A Fourie, F P Potze, N Hay, E Du Toit, M M Lippert, J Mennen
Neonates presenting with intractable cardiac failure due to vein of Galen aneurysmal malformations (VGAMs) rapidly progress to multisystem organ failure and death if left untreated. Currently the only viable treatment option is endovascular embolization. Although intracranial embolization of a neonate is a high-risk procedure, successful treatment can reverse cardiac failure and prevent neurological complications associated with VGAMs. Embolization via the arterial route is thought to have a better outcome than embolization via the venous system...
June 2010: Interventional Neuroradiology
Y Ozier
Uncontrolled hemorrhage is the most common cause of potentially preventable death in massive trauma. In addition to the early identification of potential bleeding sources and angiographic embolisation or surgical bleeding control, in-hospital management will aim at maintain tissue oxygenation with volume replacement using crystalloids, colloids and RBC. In general, RBC transfusion is recommended to maintain hemoglobin between 7-10g/dL. The complex combination of clotting factors and platelets consumption, loss and dilution, shock, hypothermia, acidosis and colloid-induced hemostatic alterations leads to coagulopathic bleeding...
November 2008: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
Yoram Vodovotz
Various stresses elicit an acute, complex inflammatory response, leading to healing but sometimes also to organ dysfunction and death. We constructed both equation-based models (EBM) and agent-based models (ABM) of various degrees of granularity--which encompass the dynamics of relevant cells, cytokines, and the resulting global tissue dysfunction--in order to begin to unravel these inflammatory interactions. The EBMs describe and predict various features of septic shock and trauma/hemorrhage (including the response to anthrax, preconditioning phenomena, and irreversible hemorrhage) and were used to simulate anti-inflammatory strategies in clinical trials...
2006: Immunologic Research
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
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
Yoram Vodovotz, Carson C Chow, John Bartels, Claudio Lagoa, Jose M Prince, Ryan M Levy, Rukmini Kumar, Judy Day, Jonathan Rubin, Greg Constantine, Timothy R Billiar, Mitchell P Fink, Gilles Clermont
Trauma and hemorrhagic shock elicit an acute inflammatory response, predisposing patients to sepsis, organ dysfunction, and death. Few approved therapies exist for these acute inflammatory states, mainly due to the complex interplay of interacting inflammatory and physiological elements working at multiple levels. Various animal models have been used to simulate these phenomena, but these models often do not replicate the clinical setting of multiple overlapping insults. Mathematical modeling of complex systems is an approach for understanding the interplay among biological interactions...
September 2006: Shock
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
Patrick Baqué, Antonio Iannelli, Fabien Dausse, Fernand de Peretti, André Bourgeon
In the trauma setting, the Focused Assessment for the Sonographic examination of the Trauma patient (FAST) accurately detects hemoperitoneum. Currently, only an approximate evaluation of the volume of free intraperitoneal fluid (FIPF) can be done by imaging modalities such as ultrasound (US). The aim of this study was to correlate the thickness of FIPF measured by US in different sites of the peritoneal cavity with the total volume of an experimental post-traumatic hemoperitoneum. An intra-abdominal collection with ongoing bleeding was simulated in eight cadavers with no previous abdominal surgery...
August 2005: Surgical and Radiologic Anatomy: SRA
Eliana S Antoniou, Steve Sund, Emile N Homsi, Leonard F Challenger, Pranela Rameshwar
The bone marrow (BM) responds to various diseases, including infections and hemorrhagic shock, by generating immune and blood cells. These cells are derived from a finite number of lymphohematopoietic stem cells (LHSC) close to the endosteal region of the BM. This study presumes that studies on LHSC involving proteomics, computational biology, and genomics could be aided by mathematical models. A theoretical model is developed to predict the responses of proliferating (P) nonproliferating (N) BM cells during acute blood loss when the Po2 in the BM is decreased...
November 2004: Shock
Ralf Dirk Rothoerl, Karl Michael Schebesch, Rupert Faltermeier, Chris Woertgen, Alexander Brawanski
In recent literature there are some reports describing cerebral blood flow measurements by a near infrared spectroscopy-based technique with indocyanine-green as an absorbant. To our knowledge there is no systematical study which evaluates this technique in comparison to absolute cerebral blood flow measurements. Ten patients suffering from head injury (n = 9) or subarachnoid hemorrhage (n = 1) were included. Twenty measurements of cerebral blood flow were performed, employing a Xenon133 clearance technique...
July 2003: Neurological Research
Srinivasu Kallakuri, John M Cavanaugh, A Cuneyt Ozaktay, Tsuneo Takebayashi
Diffuse axonal injury (DAI) is seen as widespread damage in the white matter of brain characterized by morphological changes to axons throughout the brain and brain stem. The current study attempted to investigate the effect of increasing impact energy on the presence and severity of DAI in corpus callosum (CC). DAI was induced in adult male Sprague-Dawley rats using an injury model adapted from Marmarou et al. in 1994. A 450-g cylindrical brass weight was dropped from three different heights (2.0 m, 1.5 m and 1...
February 2003: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
M M Abakumov, A V Lozhkin, V B Khvatov
A mathematical method based on a complex of capillary blood examinations was proposed and tested for detection of volume and degree of blood loss in trauma of the chest and the abdomen. This method may be used for optimization of intraoperative fluid management. It is very important when bleeding is not only into the serous cavities (blood loss is easy to evaluate during surgery) but also into the intermuscular and interstitial spaces, and also in internal hemorrhage.
2002: Khirurgiia
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