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Hemorrhage-Class2Saline

HemorrhageClass2Saline

Description

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

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. Run for 120s.

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) [152] 113   0.405% Increase
MeanArterialPressure(mmHg) GreaterThan Segment1 (88.3) [152] 89.1   0.811% Increase
BloodVolume(mL) EqualTo Segment1 (4.14e+03) 4.16e+03 0.245%   No Change
CardiacOutput(mL/min) GreaterThan Segment1 (4.27e+03) [152] 4.31e+03   0.848% Increase
HeartStrokeVolume(mL) GreaterThan Segment1 (38.0) [152] 38.2   0.442% Increase
HemoglobinContent(g) EqualTo Segment1 (616) 616 0.000101%   No Change
RespirationRate(1/min) EqualTo Segment1 (12.8) 13.1 2.16%   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

Segment 3

Provide an IV with saline at 100 mL/min with a 500 mL bag. Run for 400s.

Table 5. Data request validation results for Segment 3.
Property Name Validation Engine Value Percent Error Percent Change Notes
HeartRate(1/min) LessThan Segment2 (113) [244] 93.5   -17.2% Decrease
MeanArterialPressure(mmHg) GreaterThan Segment2 (89.1) [152] 94.1   5.68% Increase
BloodVolume(mL) EqualTo 4590 4.68e+03 2.00%   Calculated
CardiacOutput(mL/min) GreaterThan Segment2 (4.31e+03) [152] 4.82e+03   11.9% Increase
HeartStrokeVolume(mL) GreaterThan Segment2 (38.2) [152] 51.5   35.0% Increase
HemoglobinContent(g) EqualTo Segment2 (616) 616 0.000702%   No Change
RespirationRate(1/min) EqualTo Segment2 (13.1) 12.8 2.59%   No Change


Figure 3. Vitals monitor for Segment 3.


Table 6. 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 4. Select outputs from the scenario.


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