Journal of applied physiology
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Traditional monitoring technologies fail to provide accurate or early indications of hypovolemia-mediated extremis because physiological systems (as measured by vital signs) effectively compensate until circulatory failure occurs. Hypovolemia is the most life-threatening physiological condition associated with circulatory shock in hemorrhage or sepsis, and it impairs one's ability to sustain physical exertion during heat stress. ⋯ Extensive experimental evidence employing acute reductions in central blood volume (using lower-body negative pressure, blood withdrawal, heat stress, dehydration) demonstrate that compensatory reserve provides the best indicator for early and accurate assessment for compromises in blood pressure, tissue perfusion, and oxygenation in resting human subjects. Engineering challenges exist for the development of a ruggedized wearable system that can measure signals from multiple sites, improve signal-to-noise ratios, be customized for use in austere conditions (e.g., battlefield, patient transport), and be worn during strenuous physical activity.