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Hemorrhage-Class3PackedRedBloodCells

HemorrhageClass3PackedBloodCells

Description

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

Segment Validation

Segment 1

Initiate a 75 ml/min hemorrhage from the right arm. Initiate a 175 ml/min hemorrhage from the vena cava. Run for 400s.

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] 119   64.9% Increase
MeanArterialPressure(mmHg) EqualTo 57 [152] 69.1 19.2%   ~60% Normal
BloodVolume(mL) EqualTo 3800 3.85e+03 1.29%   Calculated
CardiacOutput(mL/min) EqualTo 2800 [152] 3.45e+03 20.7%   ~50% Normal
HeartStrokeVolume(mL) LessThan Baseline (80.4) [152] 29.0   -63.9% Decrease
HemoglobinContent(g) EqualTo 575 572 0.447%   Calculated
RespirationRate(1/min) GreaterThan Baseline (12.0) [152] 12.7   5.49% Increase


Figure 1. Vitals monitor for Segment 1.


Table 2. Data requests for Segment 1.
Property Name Engine Value
Patient-Weight(kg) 76.0
HeartRate(1/min) 119
HeartStrokeVolume(mL) 29.0
HeartEjectionFraction 0.312
BloodVolume(L) 3.85
ExtravascularFluidVolume(L) 34.1
MeanArterialPressure(mmHg) 69.1
SystolicArterialPressure(mmHg) 77.5
DiastolicArterialPressure(mmHg) 61.2
CardiacOutput(L/min) 3.45
HemoglobinContent(g) 572
CentralVenousPressure(mmHg) 3.13
PulmonaryCapillariesWedgePressure(mmHg) 3.96
TidalVolume(mL) 570
RespirationRate(1/min) 12.7
OxygenSaturation 0.961
CarbonDioxideSaturation 0.0287
EndTidalCarbonDioxideFraction 0.0478
EndTidalCarbonDioxidePressure(mmHg) 36.4
TotalAlveolarVentilation(L/min) 7.21
TranspulmonaryPressure(cmH2O) 4.92
CoreTemperature(degC) 37.1
SkinTemperature(degC) 32.7
RespiratoryExchangeRatio 0.782
OxygenConsumptionRate(mL/min) 346
CarbonDioxideProductionRate(mL/min) 270
GlomerularFiltrationRate(mL/min) 86.1
RenalBloodFlow(L/min) 0.765
UrineProductionRate(mL/min) 0.0159
LeftAfferentArterioleResistance(mmHg_min/mL) 0.0450
RightAfferentArterioleResistance(mmHg_min/mL) 0.0450
SystemicVascularResistance(mmHg_s/mL) 1.15
Aorta-Oxygen-PartialPressure(mmHg) 76.8
Aorta-CarbonDioxide-PartialPressure(mmHg) 40.3
VenaCava-Oxygen-PartialPressure(mmHg) 27.1
VenaCava-CarbonDioxide-PartialPressure(mmHg) 46.3
RightTubules-Sodium-Concentration(g/L) 4.61
LeftTubules-Sodium-Concentration(g/L) 4.61
Oxygen-AlveolarTransfer(mL/min) 319
CarbonDioxide-AlveolarTransfer(mL/min) -217
MyocardiumVasculature-Oxygen-PartialPressure(mmHg) 24.6
BrainVasculature-Oxygen-PartialPressure(mmHg) 24.8
MyocardiumVasculature-InFlow(mL/min) 169
BrainVasculature-InFlow(mL/min) 473
VenaCava-InFlow(mL/min) 3.78e+03
RightHeart-InFlow(mL/min) 2.49e-12
TotalHemorrhageRate(mL/s) 4.17
TotalHemorrhagedVolume(mL) 1.67e+03
BaroreceptorHeartRateScale 1.65
BaroreceptorHeartElastanceScale 0.708
BaroreceptorResistanceScale 1.19
BaroreceptorComplianceScale 0.905
ChemoreceptorHeartRateScale 1.26
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 (119) [152] 121   1.48% Increase
MeanArterialPressure(mmHg) GreaterThan Segment1 (69.1) [152] 72.8   5.32% Increase
BloodVolume(mL) EqualTo Segment1 (3.85e+03) 3.87e+03 0.436%   No Change
CardiacOutput(mL/min) GreaterThan Segment1 (3.45e+03) [152] 3.76e+03   9.05% Increase
HeartStrokeVolume(mL) GreaterThan Segment1 (29.0) [152] 31.2   7.46% Increase
HemoglobinContent(g) EqualTo Segment1 (572) 572 6.87e-05%   No Change
RespirationRate(1/min) EqualTo Segment1 (12.7) 13.3 5.19%   No Change


Figure 2. Vitals monitor for Segment 2.


Table 4. Data requests for Segment 1.
Property Name Engine Value
Patient-Weight(kg) 76.0
HeartRate(1/min) 119
HeartStrokeVolume(mL) 29.0
HeartEjectionFraction 0.312
BloodVolume(L) 3.85
ExtravascularFluidVolume(L) 34.1
MeanArterialPressure(mmHg) 69.1
SystolicArterialPressure(mmHg) 77.5
DiastolicArterialPressure(mmHg) 61.2
CardiacOutput(L/min) 3.45
HemoglobinContent(g) 572
CentralVenousPressure(mmHg) 3.13
PulmonaryCapillariesWedgePressure(mmHg) 3.96
TidalVolume(mL) 570
RespirationRate(1/min) 12.7
OxygenSaturation 0.961
CarbonDioxideSaturation 0.0287
EndTidalCarbonDioxideFraction 0.0478
EndTidalCarbonDioxidePressure(mmHg) 36.4
TotalAlveolarVentilation(L/min) 7.21
TranspulmonaryPressure(cmH2O) 4.92
CoreTemperature(degC) 37.1
SkinTemperature(degC) 32.7
RespiratoryExchangeRatio 0.782
OxygenConsumptionRate(mL/min) 346
CarbonDioxideProductionRate(mL/min) 270
GlomerularFiltrationRate(mL/min) 86.1
RenalBloodFlow(L/min) 0.765
UrineProductionRate(mL/min) 0.0159
LeftAfferentArterioleResistance(mmHg_min/mL) 0.0450
RightAfferentArterioleResistance(mmHg_min/mL) 0.0450
SystemicVascularResistance(mmHg_s/mL) 1.15
Aorta-Oxygen-PartialPressure(mmHg) 76.8
Aorta-CarbonDioxide-PartialPressure(mmHg) 40.3
VenaCava-Oxygen-PartialPressure(mmHg) 27.1
VenaCava-CarbonDioxide-PartialPressure(mmHg) 46.3
RightTubules-Sodium-Concentration(g/L) 4.61
LeftTubules-Sodium-Concentration(g/L) 4.61
Oxygen-AlveolarTransfer(mL/min) 319
CarbonDioxide-AlveolarTransfer(mL/min) -217
MyocardiumVasculature-Oxygen-PartialPressure(mmHg) 24.6
BrainVasculature-Oxygen-PartialPressure(mmHg) 24.8
MyocardiumVasculature-InFlow(mL/min) 169
BrainVasculature-InFlow(mL/min) 473
VenaCava-InFlow(mL/min) 3.78e+03
RightHeart-InFlow(mL/min) 2.49e-12
TotalHemorrhageRate(mL/s) 4.17
TotalHemorrhagedVolume(mL) 1.67e+03
BaroreceptorHeartRateScale 1.65
BaroreceptorHeartElastanceScale 0.708
BaroreceptorResistanceScale 1.19
BaroreceptorComplianceScale 0.905
ChemoreceptorHeartRateScale 1.26
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) EqualTo Segment2 (121) 92.4 26.5%   No Change
MeanArterialPressure(mmHg) GreaterThan Segment2 (72.8) [152] 84.5   16.2% Increase
BloodVolume(mL) EqualTo Segment2 (3.87e+03) 4.30e+03 10.6%   No Change
CardiacOutput(mL/min) GreaterThan Segment2 (3.76e+03) [152] 4.38e+03   16.5% Increase
HeartStrokeVolume(mL) GreaterThan Segment2 (31.2) [152] 47.4   52.0% Increase
HemoglobinContent(g) GreaterThan Segment2 (572) 615   7.45% Increase
RespirationRate(1/min) LessThan Segment2 (13.3) [152] 13.2   -0.881% Decrease


Figure 3. Vitals monitor for Segment 3.


Table 6. Data requests for Segment 1.
Property Name Engine Value
Patient-Weight(kg) 76.0
HeartRate(1/min) 119
HeartStrokeVolume(mL) 29.0
HeartEjectionFraction 0.312
BloodVolume(L) 3.85
ExtravascularFluidVolume(L) 34.1
MeanArterialPressure(mmHg) 69.1
SystolicArterialPressure(mmHg) 77.5
DiastolicArterialPressure(mmHg) 61.2
CardiacOutput(L/min) 3.45
HemoglobinContent(g) 572
CentralVenousPressure(mmHg) 3.13
PulmonaryCapillariesWedgePressure(mmHg) 3.96
TidalVolume(mL) 570
RespirationRate(1/min) 12.7
OxygenSaturation 0.961
CarbonDioxideSaturation 0.0287
EndTidalCarbonDioxideFraction 0.0478
EndTidalCarbonDioxidePressure(mmHg) 36.4
TotalAlveolarVentilation(L/min) 7.21
TranspulmonaryPressure(cmH2O) 4.92
CoreTemperature(degC) 37.1
SkinTemperature(degC) 32.7
RespiratoryExchangeRatio 0.782
OxygenConsumptionRate(mL/min) 346
CarbonDioxideProductionRate(mL/min) 270
GlomerularFiltrationRate(mL/min) 86.1
RenalBloodFlow(L/min) 0.765
UrineProductionRate(mL/min) 0.0159
LeftAfferentArterioleResistance(mmHg_min/mL) 0.0450
RightAfferentArterioleResistance(mmHg_min/mL) 0.0450
SystemicVascularResistance(mmHg_s/mL) 1.15
Aorta-Oxygen-PartialPressure(mmHg) 76.8
Aorta-CarbonDioxide-PartialPressure(mmHg) 40.3
VenaCava-Oxygen-PartialPressure(mmHg) 27.1
VenaCava-CarbonDioxide-PartialPressure(mmHg) 46.3
RightTubules-Sodium-Concentration(g/L) 4.61
LeftTubules-Sodium-Concentration(g/L) 4.61
Oxygen-AlveolarTransfer(mL/min) 319
CarbonDioxide-AlveolarTransfer(mL/min) -217
MyocardiumVasculature-Oxygen-PartialPressure(mmHg) 24.6
BrainVasculature-Oxygen-PartialPressure(mmHg) 24.8
MyocardiumVasculature-InFlow(mL/min) 169
BrainVasculature-InFlow(mL/min) 473
VenaCava-InFlow(mL/min) 3.78e+03
RightHeart-InFlow(mL/min) 2.49e-12
TotalHemorrhageRate(mL/s) 4.17
TotalHemorrhagedVolume(mL) 1.67e+03
BaroreceptorHeartRateScale 1.65
BaroreceptorHeartElastanceScale 0.708
BaroreceptorResistanceScale 1.19
BaroreceptorComplianceScale 0.905
ChemoreceptorHeartRateScale 1.26
ChemoreceptorHeartElastanceScale 1.00

Scenario Output Plots


Figure 4. Select outputs from the scenario.


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