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Integrative cardiovascular system approach to hemorrhage and fluid resuscitation

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  1. Tez No: 622312
  2. Yazar: MEHMET KAYA
  3. Danışmanlar: PROF. DR. JOHN K-J. Lİ
  4. Tez Türü: Doktora
  5. Konular: Biyomühendislik, Tıbbi Biyoloji, Bioengineering, Medical Biology
  6. Anahtar Kelimeler: Belirtilmemiş.
  7. Yıl: 2006
  8. Dil: İngilizce
  9. Üniversite: Rutgers, The State University of New Jersey-Camden
  10. Enstitü: Yurtdışı Enstitü
  11. Ana Bilim Dalı: Belirtilmemiş.
  12. Bilim Dalı: Belirtilmemiş.
  13. Sayfa Sayısı: 164

Özet

It has been reported that more than one third of early death incidents are due to hemorrhagic shock; 80% of which would be prevented if had been treated. This is why preventing hemorrhagic shock in people with uncontrolled hemorrhage is crucial and is generally performed by applying intravenous fluid therapy. Therefore, computer modeling of hemorrhage and fluid resuscitation is a valuable tool that helps to analyze the cardiovascular response to blood loss and to assess, differentiate and optimize fluid resuscitation protocols. Some of the existing mathematical models analyze only minor degrees of hemorrhage, some models attempt to evaluate the dynamics of hemorrhage without including control and autoregulation. This cardiovascular system model analyzed various crucial hemodynamic parameters for hemorrhage and examined the action of regulatory mechanisms with varying bleeding rates and durations. The model predictions were shown to predict successfully and correlate well with experimental data for given degrees of blood loss.By the use of this model the benefits of prehospital intravenous fluid therapy was analyzed. The model evaluated under what circumstances it was advantageous to start fluid administration before the patient is transferred to a definitive medical care unit. The model estimated the myocardial oxygen supply and demand during uncontrolled hemorrhage with and without fluid resuscitation. This analysis was essential since most of the exsanguinating trauma patients die because of cardiac arrest. In relation to myocardial oxygen balance, the model predicted the optimal fluid resuscitation rates by calculating the period of time required to reach myocardial oxygen deficit for any given bleeding. One significant application of this model was analysis of hemodilution since it has the ability to predict crucial hemodynamic variables. To our knowledge, the attempt to use a compartmentalized cardiovascular and total body fluid transfer model to evaluate the myocardial oxygen supply and demand relations during isovolemic hemodilution before a surgical procedure is unique. This computerized model could also provide an alternative to animal experimentation. Furthermore, it may be used as a teaching tool to train students, staff, paramedics and other medical personnel.

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