HemorrhageClass3PackedBloodCells

Description

30% blood loss (class 3 hemorrhage) then intravenous administration of packed red blood cells.

Segment Validation

Segment 1

Initiate a 100 ml/min hemorrhage from the vena cava. Run for 1175s.

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]	114		58.79%	Increase
MeanArterialPressure(mmHg)	LessThan 0.6*Baseline (57.2) [157]	41.0		-28.32%	~50% Normal
BloodVolume(mL)	EqualTo Baseline - 1960 (3.53e+03)	3.58e+03	1.45%		Calculated
CardiacOutput(mL/min)	LessThan 0.5*Baseline (2.89e+03) [157]	2.13e+03		-26.31%	~50% Normal
HeartStrokeVolume(mL)	LessThan Baseline (80.2) [157]	18.6		-76.80%	Decrease
HemoglobinContent(g)	EqualTo 575	530	-7.90%		Calculated
RespirationRate(1/min)	GreaterThan Baseline (11.9) [157]	12.3		3.28%	Increase

Figure 1. Vitals monitor for Segment 1.

Table 2. Data requests for Segment 1.

Property Name	Engine Value
Patient-Weight(kg)	75.7
HeartRate(1/min)	114
HeartStrokeVolume(mL)	18.6
HeartEjectionFraction	0.147
BloodVolume(L)	3.58
ExtravascularFluidVolume(L)	34.1
MeanArterialPressure(mmHg)	41.0
SystolicArterialPressure(mmHg)	46.6
DiastolicArterialPressure(mmHg)	35.9
CardiacOutput(L/min)	2.13
HemoglobinContent(g)	530
CentralVenousPressure(mmHg)	3.65
PulmonaryCapillariesWedgePressure(mmHg)	5.57
TidalVolume(mL)	525
RespirationRate(1/min)	12.3
OxygenSaturation	0.976
CarbonDioxideSaturation	0.0269
EndTidalCarbonDioxideFraction	0.0464
EndTidalCarbonDioxidePressure(mmHg)	35.2
TotalAlveolarVentilation(L/min)	4.60
TranspulmonaryPressure(cmH2O)	4.85
CoreTemperature(degC)	37.2
SkinTemperature(degC)	30.0
RespiratoryExchangeRatio	0.796
OxygenConsumptionRate(mL/min)	357
CarbonDioxideProductionRate(mL/min)	284
GlomerularFiltrationRate(mL/min)	14.4
RenalBloodFlow(L/min)	0.437
UrineProductionRate(mL/min)	-1.75e-18
LeftAfferentArterioleResistance(mmHg_min/mL)	0.0367
RightAfferentArterioleResistance(mmHg_min/mL)	0.0367
SystemicVascularResistance(mmHg_s/mL)	1.05
Aorta-Oxygen-PartialPressure(mmHg)	91.5
Aorta-CarbonDioxide-PartialPressure(mmHg)	36.7
VenaCava-Oxygen-PartialPressure(mmHg)	21.4
VenaCava-CarbonDioxide-PartialPressure(mmHg)	48.8
RightTubules-Sodium-Concentration(g/L)	4.05
LeftTubules-Sodium-Concentration(g/L)	4.05
Oxygen-AlveolarTransfer(mL/min)	266
CarbonDioxide-AlveolarTransfer(mL/min)	-190
MyocardiumVasculature-Oxygen-PartialPressure(mmHg)	13.8
BrainVasculature-Oxygen-PartialPressure(mmHg)	17.4
MyocardiumVasculature-Inflow(mL/min)	97.1
BrainVasculature-Inflow(mL/min)	281
VenaCava-Inflow(mL/min)	2.50e+03
RightHeart-Inflow(mL/min)	5.92e+03
TotalHemorrhageRate(mL/s)	1.67
TotalHemorrhagedVolume(mL)	1.96e+03
BaroreceptorHeartRateScale	1.59
BaroreceptorHeartElastanceScale	0.240
BaroreceptorResistanceScale	1.05
BaroreceptorComplianceScale	0.943
ChemoreceptorHeartRateScale	0.0459
ChemoreceptorHeartElastanceScale	1.00

Segment 2

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 (114) [157]	115	0.19%		Increase
MeanArterialPressure(mmHg)	GreaterThan Segment1 (41.0) [157]	50.0		22.00%	Increase
BloodVolume(mL)	EqualTo Segment1 (3.58e+03)	3.58e+03	0.01%		No Change
CardiacOutput(mL/min)	GreaterThan Segment1 (2.13e+03) [157]	2.80e+03		31.64%	Increase
HeartStrokeVolume(mL)	GreaterThan Segment1 (18.6) [157]	24.5		31.38%	Increase
HemoglobinContent(g)	EqualTo Segment1 (530)	530	0.00%		No Change
RespirationRate(1/min)	EqualTo Segment1 (12.3)	13.5	9.91%		No Change

Figure 2. Vitals monitor for Segment 2.

Table 4. Data requests for Segment 1.

Property Name	Engine Value
Patient-Weight(kg)	75.7
HeartRate(1/min)	114
HeartStrokeVolume(mL)	18.6
HeartEjectionFraction	0.147
BloodVolume(L)	3.58
ExtravascularFluidVolume(L)	34.1
MeanArterialPressure(mmHg)	41.0
SystolicArterialPressure(mmHg)	46.6
DiastolicArterialPressure(mmHg)	35.9
CardiacOutput(L/min)	2.13
HemoglobinContent(g)	530
CentralVenousPressure(mmHg)	3.65
PulmonaryCapillariesWedgePressure(mmHg)	5.57
TidalVolume(mL)	525
RespirationRate(1/min)	12.3
OxygenSaturation	0.976
CarbonDioxideSaturation	0.0269
EndTidalCarbonDioxideFraction	0.0464
EndTidalCarbonDioxidePressure(mmHg)	35.2
TotalAlveolarVentilation(L/min)	4.60
TranspulmonaryPressure(cmH2O)	4.85
CoreTemperature(degC)	37.2
SkinTemperature(degC)	30.0
RespiratoryExchangeRatio	0.796
OxygenConsumptionRate(mL/min)	357
CarbonDioxideProductionRate(mL/min)	284
GlomerularFiltrationRate(mL/min)	14.4
RenalBloodFlow(L/min)	0.437
UrineProductionRate(mL/min)	-1.75e-18
LeftAfferentArterioleResistance(mmHg_min/mL)	0.0367
RightAfferentArterioleResistance(mmHg_min/mL)	0.0367
SystemicVascularResistance(mmHg_s/mL)	1.05
Aorta-Oxygen-PartialPressure(mmHg)	91.5
Aorta-CarbonDioxide-PartialPressure(mmHg)	36.7
VenaCava-Oxygen-PartialPressure(mmHg)	21.4
VenaCava-CarbonDioxide-PartialPressure(mmHg)	48.8
RightTubules-Sodium-Concentration(g/L)	4.05
LeftTubules-Sodium-Concentration(g/L)	4.05
Oxygen-AlveolarTransfer(mL/min)	266
CarbonDioxide-AlveolarTransfer(mL/min)	-190
MyocardiumVasculature-Oxygen-PartialPressure(mmHg)	13.8
BrainVasculature-Oxygen-PartialPressure(mmHg)	17.4
MyocardiumVasculature-Inflow(mL/min)	97.1
BrainVasculature-Inflow(mL/min)	281
VenaCava-Inflow(mL/min)	2.50e+03
RightHeart-Inflow(mL/min)	5.92e+03
TotalHemorrhageRate(mL/s)	1.67
TotalHemorrhagedVolume(mL)	1.96e+03
BaroreceptorHeartRateScale	1.59
BaroreceptorHeartElastanceScale	0.240
BaroreceptorResistanceScale	1.05
BaroreceptorComplianceScale	0.943
ChemoreceptorHeartRateScale	0.0459
ChemoreceptorHeartElastanceScale	1.00

Segment 2

Provide an IV with packed red blood cells at 5 mL/min with a 2330 mL bag. Run for 2330s.

Table 5. Data request validation results for Segment 3.

Property Name	Validation	Engine Value	Percent Error	Percent Change	Notes
HeartRate(1/min)	LessThan Segment2 (115)	92.8		-19.03%	Decrease
MeanArterialPressure(mmHg)	GreaterThan Segment2 (50.0) [157]	76.4		52.85%	Increase
BloodVolume(mL)	EqualTo Segment1 + 250 (3.83e+03)	3.78e+03	-1.39%		No Change
CardiacOutput(mL/min)	GreaterThan Segment2 (2.80e+03) [157]	3.98e+03		41.96%	Increase
HeartStrokeVolume(mL)	GreaterThan Segment2 (24.5) [157]	42.9		75.33%	Increase
HemoglobinContent(g)	GreaterThan Segment2 (530)	572		8.06%	Increase
RespirationRate(1/min)	EqualTo Segment2 (13.5)	13.4	-0.89%		No Change

Figure 3. Vitals monitor for Segment 3.

Table 6. Data requests for Segment 1.

Property Name	Engine Value
Patient-Weight(kg)	75.7
HeartRate(1/min)	114
HeartStrokeVolume(mL)	18.6
HeartEjectionFraction	0.147
BloodVolume(L)	3.58
ExtravascularFluidVolume(L)	34.1
MeanArterialPressure(mmHg)	41.0
SystolicArterialPressure(mmHg)	46.6
DiastolicArterialPressure(mmHg)	35.9
CardiacOutput(L/min)	2.13
HemoglobinContent(g)	530
CentralVenousPressure(mmHg)	3.65
PulmonaryCapillariesWedgePressure(mmHg)	5.57
TidalVolume(mL)	525
RespirationRate(1/min)	12.3
OxygenSaturation	0.976
CarbonDioxideSaturation	0.0269
EndTidalCarbonDioxideFraction	0.0464
EndTidalCarbonDioxidePressure(mmHg)	35.2
TotalAlveolarVentilation(L/min)	4.60
TranspulmonaryPressure(cmH2O)	4.85
CoreTemperature(degC)	37.2
SkinTemperature(degC)	30.0
RespiratoryExchangeRatio	0.796
OxygenConsumptionRate(mL/min)	357
CarbonDioxideProductionRate(mL/min)	284
GlomerularFiltrationRate(mL/min)	14.4
RenalBloodFlow(L/min)	0.437
UrineProductionRate(mL/min)	-1.75e-18
LeftAfferentArterioleResistance(mmHg_min/mL)	0.0367
RightAfferentArterioleResistance(mmHg_min/mL)	0.0367
SystemicVascularResistance(mmHg_s/mL)	1.05
Aorta-Oxygen-PartialPressure(mmHg)	91.5
Aorta-CarbonDioxide-PartialPressure(mmHg)	36.7
VenaCava-Oxygen-PartialPressure(mmHg)	21.4
VenaCava-CarbonDioxide-PartialPressure(mmHg)	48.8
RightTubules-Sodium-Concentration(g/L)	4.05
LeftTubules-Sodium-Concentration(g/L)	4.05
Oxygen-AlveolarTransfer(mL/min)	266
CarbonDioxide-AlveolarTransfer(mL/min)	-190
MyocardiumVasculature-Oxygen-PartialPressure(mmHg)	13.8
BrainVasculature-Oxygen-PartialPressure(mmHg)	17.4
MyocardiumVasculature-Inflow(mL/min)	97.1
BrainVasculature-Inflow(mL/min)	281
VenaCava-Inflow(mL/min)	2.50e+03
RightHeart-Inflow(mL/min)	5.92e+03
TotalHemorrhageRate(mL/s)	1.67
TotalHemorrhagedVolume(mL)	1.96e+03
BaroreceptorHeartRateScale	1.59
BaroreceptorHeartElastanceScale	0.240
BaroreceptorResistanceScale	1.05
BaroreceptorComplianceScale	0.943
ChemoreceptorHeartRateScale	0.0459
ChemoreceptorHeartElastanceScale	1.00

Scenario Output Plots

Figure 4. Select outputs from the scenario.