Accession Number : ADA555903


Title :   Physiologic Waveform Analysis for Early Detection of Hemorrhage during Transport and Higher Echelon Medical Care of Combat Casualties


Descriptive Note : Annual rept. 15 Oct 2010-14 Oct 2011


Corporate Author : MICHIGAN STATE UNIV EAST LANSING


Personal Author(s) : Mukkamala, Ramakrishna


Full Text : https://apps.dtic.mil/dtic/tr/fulltext/u2/a555903.pdf


Report Date : Nov 2011


Pagination or Media Count : 101


Abstract : Early detection of hemorrhage is crucial for managing combat casualties. However, mean arterial blood pressure (ABP) and other vital signs are late indicators of a bleed. By contrast, cardiac stroke volume (SV), cardiac end-diastolic volume (EDV), and autonomic nervous system (ANS) activity can provide timely warning of blood volume loss. However, existing methods for their measurement are invasive and/or require a point-of-care operator. On the other hand, a peripheral ABP waveform can be measured non-invasively and automatically with commercial devices that are amenable to most combat casualties during evacuation and medical care thereafter. We have conceived techniques to track SV, EDV, and ANS activity by mathematical analysis of a peripheral ABP waveform and simpler non-invasive waveforms. Our objective is to prove the efficacy of these techniques in the context of early hypovolemia detection. We are investigating the techniques based on existing data from healthy humans exposed to lower body negative pressure (LBNP) ? a model of early bleeding in conscious subjects. Our most significant results to date are that the techniques can accurately estimate relative changes in cardiac volumes during progressive LBNP and recovery and that these estimates can provide a sensitive marker of the degree of LBNP. With further research, the techniques may potentially be used to help manage combat casualties during transport and higher echelon care.


Descriptors :   *BLOOD PRESSURE , *CASUALTIES , *HEMORRHAGE , *MILITARY MEDICINE , AUTONOMIC NERVOUS SYSTEM , BLOOD VOLUME , COMMERCIAL EQUIPMENT , CONTRAST , DETECTION , ESTIMATES , EVACUATION , EXPOSURE(GENERAL) , HUMANS , INDICATORS , MEDICAL SERVICES , MODELS , PHYSIOLOGY , RECOVERY , SIGNS AND SYMPTOMS , TIMELINESS , TRANSPORT , WARFARE , WAVEFORMS


Subject Categories : Medicine and Medical Research


Distribution Statement : APPROVED FOR PUBLIC RELEASE