Oxygen transport characterization of a human model of progressive hemorrhage

Kevin R. Ward, Mohamad H. Tiba, Kathy L. Ryan, Ivo P Torres Filho, Caroline A. Rickards, Tarryn Witten, Babs R. Soller, David Ludwig, Victor A. Convertino

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

Background: Hemorrhage continues to be a leading cause of death from trauma sustained both in combat and in the civilian setting. New models of hemorrhage may add value in both improving our understanding of the physiologic responses to severe bleeding and as platforms to develop and test new monitoring and therapeutic techniques. We examined changes in oxygen transport produced by central volume redistribution in humans using lower body negative pressure (LBNP) as a potential mimetic of hemorrhage. Methods and results: In 20 healthy volunteers, systemic oxygen delivery and oxygen consumption, skeletal muscle oxygenation and oral mucosa perfusion were measured over increasing levels of LBNP to the point of hemodynamic decompensation. With sequential reductions in central blood volume, progressive reductions in oxygen delivery and tissue oxygenation and perfusion parameters were noted, while no changes were observed in systemic oxygen uptake or markers of anaerobic metabolism in the blood (e.g., lactate, base excess). While blood pressure decreased and heart rate increased during LBNP, these changes occurred later than the reductions in tissue oxygenation and perfusion. Conclusions: These findings indicate that LBNP induces changes in oxygen transport consistent with the compensatory phase of hemorrhage, but that a frank state of shock (delivery-dependent oxygen consumption) does not occur. LBNP may therefore serve as a model to better understand a variety of compensatory physiological changes that occur during the pre-shock phase of hemorrhage in conscious humans. As such, LBNP may be a useful platform from which to develop and test new monitoring capabilities for identifying the need for intervention during the early phases of hemorrhage to prevent a patient's progression to overt shock.

Original languageEnglish
Pages (from-to)987-993
Number of pages7
JournalResuscitation
Volume81
Issue number8
DOIs
StatePublished - Aug 1 2010

Fingerprint

Lower Body Negative Pressure
Hemorrhage
Oxygen
Shock
Perfusion
Oxygen Consumption
Anaerobiosis
Mouth Mucosa
Blood Volume
Cause of Death
Lactic Acid
Healthy Volunteers
Skeletal Muscle
Heart Rate
Hemodynamics
Blood Pressure
Wounds and Injuries

Keywords

  • Combat casualty
  • Hemorrhage
  • Lower body negative pressure
  • Monitoring
  • Tissue oxygenation
  • Trauma

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Emergency
  • Emergency Medicine

Cite this

Ward, K. R., Tiba, M. H., Ryan, K. L., Filho, I. P. T., Rickards, C. A., Witten, T., ... Convertino, V. A. (2010). Oxygen transport characterization of a human model of progressive hemorrhage. Resuscitation, 81(8), 987-993. https://doi.org/10.1016/j.resuscitation.2010.03.027

Oxygen transport characterization of a human model of progressive hemorrhage. / Ward, Kevin R.; Tiba, Mohamad H.; Ryan, Kathy L.; Filho, Ivo P Torres; Rickards, Caroline A.; Witten, Tarryn; Soller, Babs R.; Ludwig, David; Convertino, Victor A.

In: Resuscitation, Vol. 81, No. 8, 01.08.2010, p. 987-993.

Research output: Contribution to journalArticle

Ward, KR, Tiba, MH, Ryan, KL, Filho, IPT, Rickards, CA, Witten, T, Soller, BR, Ludwig, D & Convertino, VA 2010, 'Oxygen transport characterization of a human model of progressive hemorrhage', Resuscitation, vol. 81, no. 8, pp. 987-993. https://doi.org/10.1016/j.resuscitation.2010.03.027
Ward KR, Tiba MH, Ryan KL, Filho IPT, Rickards CA, Witten T et al. Oxygen transport characterization of a human model of progressive hemorrhage. Resuscitation. 2010 Aug 1;81(8):987-993. https://doi.org/10.1016/j.resuscitation.2010.03.027
Ward, Kevin R. ; Tiba, Mohamad H. ; Ryan, Kathy L. ; Filho, Ivo P Torres ; Rickards, Caroline A. ; Witten, Tarryn ; Soller, Babs R. ; Ludwig, David ; Convertino, Victor A. / Oxygen transport characterization of a human model of progressive hemorrhage. In: Resuscitation. 2010 ; Vol. 81, No. 8. pp. 987-993.
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