HemorrhageSollerEtAlSurvivors
Description
Replicating the experiment in Soller et al for the group of survivor swine. Swine were given a controlled bleed for 15 minutes at a rate of 24 ml/kg. The controlled bleed was stopped and a spleen injury was applied for an uncontrolled bleed. After 15 additional minutes, fluids were given (assuming saline) to maintain mAP at 65 mmHg (measured MAP was not 65 throughout study). Measurements were taken at 0 minutes (end of uncontrolled hemorrhage), 15 minutes, 60 minutes and 120 minutes. The amount of blood lost and the amount of fluid given was also recorded at these intervals allowing us to replicate the experiment.
Hemorrhage Soller Et Al Survivors
Description
Replicating the experiment in Soller et al for the group of survivor swine. Swine were given a controlled bleed for 15 minutes at a rate of 24 ml/kg. The controlled bleed was stopped and a spleen injury was applied for an uncontrolled bleed. After 15 additional minutes, fluids were given (assuming saline) to maintain mAP at 65 mmHg (measured MAP was not 65 throughout study). Measurements were taken at 0 minutes (end of uncontrolled hemorrhage), 15 minutes, 60 minutes and 120 minutes. The amount of blood lost and the amount of fluid given was also recorded at these intervals allowing us to replicate the experiment.
This is a link to Soller, et al.
Segment Validation
Segment 1
Lungs were mechanically ventilated in volume-controlled mode with a FiO2 of 0.21 and a PEEP of 5 cm H2O. Tidal volumes were adjusted to 7 to 10 mL/kg at 15 breaths per minute (fixed rate) to achieve a PaCO2 between 35 mmHg and 40 mmHg.
| Mode | VT (L) | Flow (L/min) | TI (s) | RR (bpm) | PEEP (cmH2O) | FiO2 |
|---|---|---|---|---|---|---|
| VC-CMV | 0.475 | 29 | 1.0 | 15 | 5 | 0.21 |
Run to homeostasis. Initiate a controlled hemorrhage corresponding to 24 mL/kg for a 39 kg female pig. 59kg*24 ml/kg = 1416 ml -> / 15 min = 94.4 ml/min. This was distributed across the femoral artery and the vena cava. Simulate for 15 minutes.
| Property Name | Validation | Engine Value | Percent Error | Percent Change | Notes |
|---|---|---|---|---|---|
| HeartRate(1/min) | EqualTo 102 [361] | 115 | 12.43% | ||
| MeanArterialPressure(mmHg) | EqualTo 67 [361] | 77.7 | 15.98% | ||
| BloodVolume(mL) | EqualTo 2800 [361] | 2.81e+03 | 0.37% | ||
| CardiacOutput(mL/min) | EqualTo 4300 [361] | 3.45e+03 | -19.76% | ||
| Hemoglobin-BloodConcentration(g/dL) | EqualTo 9.8 [361] | 13.8 | 40.93% | ||
| TotalHemorrhagedVolume(mL) | EqualTo 1400 [361] | 1.42e+03 | 1.14% | ||
| BloodPH | EqualTo 7.32 [361] | 7.37 | 0.68% | ||
| VenaCava-Lactate-Molarity(mmol/L) | EqualTo 2.2 [361] | 2.08 | -5.28% |
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Segment 2
Stop the controlled hemorrhages. Stop the controlled hemorrhages. Initiate an uncontrolled spleen hemorrhage corresponding to 6 mL/kg for a 59 kg female pig. 59kg*6 ml/kg = 350ml -> / 15 min = 24 ml/min Simulate for 15 minutes.
| Property Name | Validation | Engine Value | Percent Error | Percent Change | Notes |
|---|---|---|---|---|---|
| HeartRate(1/min) | EqualTo 1.86*Segment1 (213) [361] | 124 | -42.10% | ||
| MeanArterialPressure(mmHg) | EqualTo 0.55*Segment1 (42.7) [361] | 35.0 | -18.20% | ||
| BloodVolume(mL) | EqualTo 2450 [361] | 2.34e+03 | -4.44% | ||
| CardiacOutput(mL/min) | EqualTo 0.39*Segment1 (1.35e+03) [361] | 1.54e+03 | 14.57% | ||
| Hemoglobin-BloodConcentration(g/dL) | EqualTo 1.01*Segment1 (13.9) [361] | 13.8 | -1.14% | ||
| TotalHemorrhagedVolume(mL) | EqualTo 1750 [361] | 1.89e+03 | 7.91% | ||
| BloodPH | EqualTo 0.982*Segment1 (7.24) [361] | 7.36 | 1.70% | ||
| VenaCava-Lactate-Molarity(mmol/L) | EqualTo 2.045*Segment1 (4.26) [361] | 4.70 | 10.20% |
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Segment 3
Continue the uncontrolled hemorrhage corresponding to 4 mL/kg for a 59 kg female pig. 59kg*4 ml/kg = 236ml -> / 45 min = 5.2 ml/min Initiate fluid resuscitation corresponding to 16 mL/kg for a 59 kg female pig. 59kg*16 ml/kg = 944ml -> / 45 min = 21 ml/min. Simulate for 45 minutes.
| Property Name | Validation | Engine Value | Percent Error | Percent Change | Notes |
|---|---|---|---|---|---|
| HeartRate(1/min) | EqualTo 1.04*Segment2 (128) [361] | 123 | -3.85% | ||
| MeanArterialPressure(mmHg) | EqualTo 1.49*Segment2 (52.1) [361] | 35.0 | -32.86% | ||
| BloodVolume(mL) | EqualTo 2214 [361] | 1.95e+03 | -11.82% | ||
| CardiacOutput(mL/min) | EqualTo 1.43*Segment2 (2.20e+03) [361] | 1.60e+03 | -27.46% | ||
| Hemoglobin-BloodConcentration(g/dL) | EqualTo 0.758*Segment2 (10.5) [361] | 13.0 | 23.91% | ||
| TotalHemorrhagedVolume(mL) | EqualTo 1636 [361] | 2.79e+03 | 70.44% | ||
| BloodPH | EqualTo 1.0167*Segment2 (7.48) [361] | 7.34 | -1.89% | ||
| VenaCava-Lactate-Molarity(mmol/L) | EqualTo 1.09*Segment2 (5.12) [361] | 13.8 | 169.98% |
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Segment 4
Continue the uncontrolled hemorrhage corresponding to 1 mL/kg for a 59 kg female pig. 59kg*1 ml/kg = 59ml -> / 60 min = 1 ml/min. Initiate fluid resuscitation corresponding to 2 mL/kg for a 59 kg female pig. 59kg*2 ml/kg = 118ml -> / 60 min = 2 ml/min. Simulate for 60 minutes.
| Property Name | Validation | Engine Value | Percent Error | Percent Change | Notes |
|---|---|---|---|---|---|
| HeartRate(1/min) | EqualTo 1.05*Segment3 (130) [361] | 123 | -4.88% | ||
| MeanArterialPressure(mmHg) | EqualTo 1.02*Segment3 (35.7) [361] | 56.8 | 59.21% | ||
| BloodVolume(mL) | EqualTo 2274 [361] | 2.27e+03 | -0.25% | ||
| CardiacOutput(mL/min) | EqualTo 0.943*Segment3 (1.51e+03) [361] | 2.64e+03 | 75.31% | ||
| Hemoglobin-BloodConcentration(g/dL) | EqualTo 1.03*Segment3 (13.3) [361] | 11.1 | -16.51% | ||
| TotalHemorrhagedVolume(mL) | EqualTo 1636 [361] | 2.79e+03 | 70.44% | ||
| BloodPH | EqualTo 1.003*Segment3 (7.36) [361] | 7.32 | -0.52% | ||
| VenaCava-Lactate-Molarity(mmol/L) | EqualTo 0.796*Segment3 (11.0) [361] | 25.2 | 129.05% |
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Scenario Output Plots
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