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) [152]	112		56.0%	Increase
MeanArterialPressure(mmHg)	EqualTo 76 [152]	88.3	15.0%		~80% Normal
BloodVolume(mL)	EqualTo 4190	4.14e+03	1.08%		Calculated
CardiacOutput(mL/min)	[3.64e+03,3.92e+03] [152]	4.27e+03	8.56%		~65-70% Normal
HeartStrokeVolume(mL)	LessThan Baseline (80.4) [152]	38.0		-52.7%	Decrease
HemoglobinContent(g)	EqualTo 630	616	2.27%		Calculated
RespirationRate(1/min)	EqualTo Baseline (12.0) [152]	12.8	6.61%		No Change

Figure 1. Vitals monitor for Segment 1.

Table 2. Data requests for Segment 1.

Property Name	Engine Value
Patient-Weight(kg)	76.2
HeartRate(1/min)	112
HeartStrokeVolume(mL)	38.0
HeartEjectionFraction	0.399
BloodVolume(L)	4.14
ExtravascularFluidVolume(L)	34.1
MeanArterialPressure(mmHg)	88.3
SystolicArterialPressure(mmHg)	98.5
DiastolicArterialPressure(mmHg)	77.6
CardiacOutput(L/min)	4.27
HemoglobinContent(g)	616
CentralVenousPressure(mmHg)	3.14
PulmonaryCapillariesWedgePressure(mmHg)	4.09
TidalVolume(mL)	578
RespirationRate(1/min)	12.8
OxygenSaturation	0.965
CarbonDioxideSaturation	0.0285
EndTidalCarbonDioxideFraction	0.0486
EndTidalCarbonDioxidePressure(mmHg)	37.0
TotalAlveolarVentilation(L/min)	7.41
TranspulmonaryPressure(cmH2O)	6.29
CoreTemperature(degC)	37.2
SkinTemperature(degC)	32.7
RespiratoryExchangeRatio	0.793
OxygenConsumptionRate(mL/min)	324
CarbonDioxideProductionRate(mL/min)	257
GlomerularFiltrationRate(mL/min)	84.0
RenalBloodFlow(L/min)	0.709
UrineProductionRate(mL/min)	0.105
LeftAfferentArterioleResistance(mmHg_min/mL)	0.0502
RightAfferentArterioleResistance(mmHg_min/mL)	0.0502
SystemicVascularResistance(mmHg_s/mL)	1.20
Aorta-Oxygen-PartialPressure(mmHg)	80.8
Aorta-CarbonDioxide-PartialPressure(mmHg)	40.6
VenaCava-Oxygen-PartialPressure(mmHg)	29.7
VenaCava-CarbonDioxide-PartialPressure(mmHg)	45.9
RightTubules-Sodium-Concentration(g/L)	4.74
LeftTubules-Sodium-Concentration(g/L)	4.74
Oxygen-AlveolarTransfer(mL/min)	264
CarbonDioxide-AlveolarTransfer(mL/min)	-182
MyocardiumVasculature-Oxygen-PartialPressure(mmHg)	29.3
BrainVasculature-Oxygen-PartialPressure(mmHg)	28.6
MyocardiumVasculature-InFlow(mL/min)	142
BrainVasculature-InFlow(mL/min)	436
VenaCava-InFlow(mL/min)	4.16e+03
RightHeart-InFlow(mL/min)	42.6
TotalHemorrhageRate(mL/s)	2.33
TotalHemorrhagedVolume(mL)	1.38e+03
BaroreceptorHeartRateScale	1.57
BaroreceptorHeartElastanceScale	1.00
BaroreceptorResistanceScale	1.29
BaroreceptorComplianceScale	0.861
ChemoreceptorHeartRateScale	0.509
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 400s.

Table 3. Data request validation results for Segment 2.

Property Name	Validation	Engine Value	Percent Error	Percent Change	Notes
HeartRate(1/min)	LessThan Segment1 (112) [244]	94.0		-16.3%	Decrease
MeanArterialPressure(mmHg)	GreaterThan Segment1 (88.3) [152]	94.1		6.49%	Increase
BloodVolume(mL)	EqualTo 4590	4.67e+03	1.78%		Calculated
CardiacOutput(mL/min)	GreaterThan Segment1 (4.27e+03) [152]	4.84e+03		13.3%	Increase
HeartStrokeVolume(mL)	GreaterThan Segment1 (38.0) [152]	51.5		35.4%	Increase
HemoglobinContent(g)	EqualTo 690	690	0.0346%		Calculated
RespirationRate(1/min)	EqualTo Segment1 (12.8)	12.8	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)	76.2
HeartRate(1/min)	112
HeartStrokeVolume(mL)	38.0
HeartEjectionFraction	0.399
BloodVolume(L)	4.14
ExtravascularFluidVolume(L)	34.1
MeanArterialPressure(mmHg)	88.3
SystolicArterialPressure(mmHg)	98.5
DiastolicArterialPressure(mmHg)	77.6
CardiacOutput(L/min)	4.27
HemoglobinContent(g)	616
CentralVenousPressure(mmHg)	3.14
PulmonaryCapillariesWedgePressure(mmHg)	4.09
TidalVolume(mL)	578
RespirationRate(1/min)	12.8
OxygenSaturation	0.965
CarbonDioxideSaturation	0.0285
EndTidalCarbonDioxideFraction	0.0486
EndTidalCarbonDioxidePressure(mmHg)	37.0
TotalAlveolarVentilation(L/min)	7.41
TranspulmonaryPressure(cmH2O)	6.29
CoreTemperature(degC)	37.2
SkinTemperature(degC)	32.7
RespiratoryExchangeRatio	0.793
OxygenConsumptionRate(mL/min)	324
CarbonDioxideProductionRate(mL/min)	257
GlomerularFiltrationRate(mL/min)	84.0
RenalBloodFlow(L/min)	0.709
UrineProductionRate(mL/min)	0.105
LeftAfferentArterioleResistance(mmHg_min/mL)	0.0502
RightAfferentArterioleResistance(mmHg_min/mL)	0.0502
SystemicVascularResistance(mmHg_s/mL)	1.20
Aorta-Oxygen-PartialPressure(mmHg)	80.8
Aorta-CarbonDioxide-PartialPressure(mmHg)	40.6
VenaCava-Oxygen-PartialPressure(mmHg)	29.7
VenaCava-CarbonDioxide-PartialPressure(mmHg)	45.9
RightTubules-Sodium-Concentration(g/L)	4.74
LeftTubules-Sodium-Concentration(g/L)	4.74
Oxygen-AlveolarTransfer(mL/min)	264
CarbonDioxide-AlveolarTransfer(mL/min)	-182
MyocardiumVasculature-Oxygen-PartialPressure(mmHg)	29.3
BrainVasculature-Oxygen-PartialPressure(mmHg)	28.6
MyocardiumVasculature-InFlow(mL/min)	142
BrainVasculature-InFlow(mL/min)	436
VenaCava-InFlow(mL/min)	4.16e+03
RightHeart-InFlow(mL/min)	42.6
TotalHemorrhageRate(mL/s)	2.33
TotalHemorrhagedVolume(mL)	1.38e+03
BaroreceptorHeartRateScale	1.57
BaroreceptorHeartElastanceScale	1.00
BaroreceptorResistanceScale	1.29
BaroreceptorComplianceScale	0.861
ChemoreceptorHeartRateScale	0.509
ChemoreceptorHeartElastanceScale	1.00

Scenario Output Plots

Figure 3. Select outputs from the scenario.