HemorrhageClass2Blood

Description

25% blood loss (class 2 hemorrhage) then intravenous administration of whole blood.

Segment Validation

Segment 1

Initiate a 90 ml/min hemorrhage from the right arm. Initiate a 50 ml/min hemorrhage from the vena cava. Run for 590s.

Table 1. Data request validation results for Segment 1.

Property Name	Validation	Engine Value	Percent Error	Percent Change	Notes
HeartRate(1/min)	GreaterThan Baseline (72.0) [157]	106		46.60%	Increase
MeanArterialPressure(mmHg)	LessThan Baseline (95.3) [157]	90.9		-4.59%	65-90%
BloodVolume(mL)	EqualTo Baseline -1357 (4.13e+03)	4.14e+03	0.15%		Calculated
CardiacOutput(mL/min)	LessThan Baseline (5.78e+03) [157]	4.39e+03		-24.08%	50-90%
HeartStrokeVolume(mL)	LessThan Baseline (80.2) [157]	41.5		-48.21%	Decrease
HemoglobinContent(g)	EqualTo 620	616	-0.71%		Calculated
RespirationRate(1/min)	EqualTo Baseline (11.9) [157]	12.5	5.00%		No Change

Figure 1. Vitals monitor for Segment 1.

Table 2. Data requests for Segment 1.

Property Name	Engine Value
Patient-Weight(kg)	76.4
HeartRate(1/min)	106
HeartStrokeVolume(mL)	41.5
HeartEjectionFraction	0.419
BloodVolume(L)	4.14
ExtravascularFluidVolume(L)	34.1
MeanArterialPressure(mmHg)	90.9
SystolicArterialPressure(mmHg)	102
DiastolicArterialPressure(mmHg)	79.2
CardiacOutput(L/min)	4.39
HemoglobinContent(g)	616
CentralVenousPressure(mmHg)	2.99
PulmonaryCapillariesWedgePressure(mmHg)	4.28
TidalVolume(mL)	535
RespirationRate(1/min)	12.5
OxygenSaturation	0.975
CarbonDioxideSaturation	0.0262
EndTidalCarbonDioxideFraction	0.0493
EndTidalCarbonDioxidePressure(mmHg)	37.5
TotalAlveolarVentilation(L/min)	4.80
TranspulmonaryPressure(cmH2O)	5.88
CoreTemperature(degC)	37.1
SkinTemperature(degC)	31.0
RespiratoryExchangeRatio	0.785
OxygenConsumptionRate(mL/min)	312
CarbonDioxideProductionRate(mL/min)	245
GlomerularFiltrationRate(mL/min)	107
RenalBloodFlow(L/min)	0.888
UrineProductionRate(mL/min)	0.606
LeftAfferentArterioleResistance(mmHg_min/mL)	0.0462
RightAfferentArterioleResistance(mmHg_min/mL)	0.0462
SystemicVascularResistance(mmHg_s/mL)	1.20
Aorta-Oxygen-PartialPressure(mmHg)	91.6
Aorta-CarbonDioxide-PartialPressure(mmHg)	38.7
VenaCava-Oxygen-PartialPressure(mmHg)	31.7
VenaCava-CarbonDioxide-PartialPressure(mmHg)	45.9
RightTubules-Sodium-Concentration(g/L)	4.11
LeftTubules-Sodium-Concentration(g/L)	4.11
Oxygen-AlveolarTransfer(mL/min)	451
CarbonDioxide-AlveolarTransfer(mL/min)	-385
MyocardiumVasculature-Oxygen-PartialPressure(mmHg)	31.8
BrainVasculature-Oxygen-PartialPressure(mmHg)	30.5
MyocardiumVasculature-Inflow(mL/min)	184
BrainVasculature-Inflow(mL/min)	529
VenaCava-Inflow(mL/min)	4.43e+03
RightHeart-Inflow(mL/min)	4.95e-12
TotalHemorrhageRate(mL/s)	2.33
TotalHemorrhagedVolume(mL)	1.38e+03
BaroreceptorHeartRateScale	1.47
BaroreceptorHeartElastanceScale	1.02
BaroreceptorResistanceScale	1.27
BaroreceptorComplianceScale	0.877
ChemoreceptorHeartRateScale	0.0570
ChemoreceptorHeartElastanceScale	1.00

Segment 2

Stop the hemorrhages. Provide an IV with whole blood at 100 mL/min with a 500 mL bag. Run for 600s.

Table 3. Data request validation results for Segment 2.

Property Name	Validation	Engine Value	Percent Error	Notes
HeartRate(1/min)	GreaterThan Segment1 (106) [157]	89.5	-15.24%	Increase
MeanArterialPressure(mmHg)	EqualTo Segment1 (90.9) [157]	94.3	3.72%	~Equal
BloodVolume(mL)	EqualTo Segment1 + 500 (4.64e+03)	4.66e+03	0.40%	No Change
CardiacOutput(mL/min)	EqualTo Segment1 (4.39e+03) [157]	5.11e+03	16.36%	~Equal
HeartStrokeVolume(mL)	EqualTo Segment1 (41.5) [157]	57.0	37.27%	~Equal
HemoglobinContent(g)	EqualTo Segment1 (616)	689	12.00%	No Change
RespirationRate(1/min)	EqualTo Segment1 (12.5)	12.5	0.00%	No Change

Figure 2. Vitals monitor for Segment 2.

Table 4. Data requests for Segment 1.

Property Name	Engine Value
Patient-Weight(kg)	76.4
HeartRate(1/min)	106
HeartStrokeVolume(mL)	41.5
HeartEjectionFraction	0.419
BloodVolume(L)	4.14
ExtravascularFluidVolume(L)	34.1
MeanArterialPressure(mmHg)	90.9
SystolicArterialPressure(mmHg)	102
DiastolicArterialPressure(mmHg)	79.2
CardiacOutput(L/min)	4.39
HemoglobinContent(g)	616
CentralVenousPressure(mmHg)	2.99
PulmonaryCapillariesWedgePressure(mmHg)	4.28
TidalVolume(mL)	535
RespirationRate(1/min)	12.5
OxygenSaturation	0.975
CarbonDioxideSaturation	0.0262
EndTidalCarbonDioxideFraction	0.0493
EndTidalCarbonDioxidePressure(mmHg)	37.5
TotalAlveolarVentilation(L/min)	4.80
TranspulmonaryPressure(cmH2O)	5.88
CoreTemperature(degC)	37.1
SkinTemperature(degC)	31.0
RespiratoryExchangeRatio	0.785
OxygenConsumptionRate(mL/min)	312
CarbonDioxideProductionRate(mL/min)	245
GlomerularFiltrationRate(mL/min)	107
RenalBloodFlow(L/min)	0.888
UrineProductionRate(mL/min)	0.606
LeftAfferentArterioleResistance(mmHg_min/mL)	0.0462
RightAfferentArterioleResistance(mmHg_min/mL)	0.0462
SystemicVascularResistance(mmHg_s/mL)	1.20
Aorta-Oxygen-PartialPressure(mmHg)	91.6
Aorta-CarbonDioxide-PartialPressure(mmHg)	38.7
VenaCava-Oxygen-PartialPressure(mmHg)	31.7
VenaCava-CarbonDioxide-PartialPressure(mmHg)	45.9
RightTubules-Sodium-Concentration(g/L)	4.11
LeftTubules-Sodium-Concentration(g/L)	4.11
Oxygen-AlveolarTransfer(mL/min)	451
CarbonDioxide-AlveolarTransfer(mL/min)	-385
MyocardiumVasculature-Oxygen-PartialPressure(mmHg)	31.8
BrainVasculature-Oxygen-PartialPressure(mmHg)	30.5
MyocardiumVasculature-Inflow(mL/min)	184
BrainVasculature-Inflow(mL/min)	529
VenaCava-Inflow(mL/min)	4.43e+03
RightHeart-Inflow(mL/min)	4.95e-12
TotalHemorrhageRate(mL/s)	2.33
TotalHemorrhagedVolume(mL)	1.38e+03
BaroreceptorHeartRateScale	1.47
BaroreceptorHeartElastanceScale	1.02
BaroreceptorResistanceScale	1.27
BaroreceptorComplianceScale	0.877
ChemoreceptorHeartRateScale	0.0570
ChemoreceptorHeartElastanceScale	1.00

Scenario Output Plots

Figure 3. Select outputs from the scenario.