The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Oct 2015
Blood pressure and heart rate from the arterial blood pressure waveform can reliably estimate cardiac output in a conscious sheep model of multiple hemorrhages and resuscitation using computer machine learning approaches.
This study was a first step to facilitate the development of automated decision support systems using cardiac output (CO) for combat casualty care. Such systems remain a practical challenge in battlefield and prehospital settings. In these environments, reliable CO estimation using blood pressure (BP) and heart rate (HR) may provide additional capabilities for diagnosis and treatment of trauma patients. The aim of this study was to demonstrate that continuous BP and HR from the arterial BP waveform coupled with machine learning (ML) can reliably estimate CO in a conscious sheep model of multiple hemorrhages and resuscitation. ⋯ This study showed that CO can be reliably estimated using BPs and HR from the arterial BP waveform in combination with ML. A next step will be to test this approach using noninvasive BPs and HR.
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J Trauma Acute Care Surg · Oct 2015
Hyperoxic resuscitation improves survival but worsens neurologic outcome in a rat polytrauma model of traumatic brain injury plus hemorrhagic shock.
Many traumatic brain injury (TBI) patients experience additional injuries, including those that result in hemorrhagic shock (HS). Interactions between HS and TBI can include reduced brain O2 delivery, resulting in partial cerebral ischemia and worse neurologic outcome. This study tested the hypothesis that inspiration of 100% O2 during resuscitation following TBI and HS improves survival, reduces brain lesion volume, and improves neurologic outcome compared with resuscitation in the absence of supplemental O2. ⋯ The survival of rats following controlled cortical impact plus HS was greater following hyperoxic resuscitation. In contrast, neurologic outcomes were better following normoxic resuscitation.