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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) [157] 106   46.60% Increase
MeanArterialPressure(mmHg) LessThan Baseline (95.3) [157] 90.9   -4.59% 65-90%
BloodVolume(mL) EqualTo Baseline - 1375 (4.11e+03) 4.14e+03 0.59%   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. 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) GreaterThan Segment1 (106) [157] 105 -0.39%   Increase
MeanArterialPressure(mmHg) EqualTo Segment1 (90.9) [157] 90.4 -0.54%   ~Equal
BloodVolume(mL) EqualTo Segment1 (4.14e+03) 4.14e+03 0.13%   No Change
CardiacOutput(mL/min) EqualTo Segment1 (4.39e+03) [157] 4.48e+03 2.16%   ~Equal
HeartStrokeVolume(mL) EqualTo Segment1 (41.5) [157] 42.6 2.56%   ~Equal
HemoglobinContent(g) EqualTo Segment1 (616) 616 0.00%   No Change
RespirationRate(1/min) EqualTo Segment1 (12.5) 12.8 2.13%   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

Segment 3

Provide an IV with saline at 100 mL/min with a 500 mL bag. Run for 600s.

Table 5. Data request validation results for Segment 3.
Property Name Validation Engine Value Percent Error Percent Change Notes
HeartRate(1/min) LessThan Segment2 (105) [253] 89.5   -14.96% Decrease
MeanArterialPressure(mmHg) GreaterThan Segment2 (90.4) [157] 94.3   4.28% Increase
BloodVolume(mL) EqualTo Segment2 + 500 (4.64e+03) 4.65e+03 0.27%   Calculated
CardiacOutput(mL/min) GreaterThan Segment2 (4.48e+03) [157] 5.10e+03   13.68% Increase
HeartStrokeVolume(mL) GreaterThan Segment2 (42.6) [157] 56.9   33.67% Increase
HemoglobinContent(g) EqualTo Segment2 (616) 616 0.00%   No Change
RespirationRate(1/min) EqualTo Segment2 (12.8) 12.4 -2.49%   No Change


Figure 3. Vitals monitor for Segment 3.


Table 6. 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 4. Select outputs from the scenario.


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