Development of an Algorithm for Prediction of Onset of Hemodynamic Instability in Humans
Summary
Hemorrhagic shock is typically identified by the degree of hypotension that develops as a result of blood loss and remains a leading cause of death on the battlefield as well as worldwide.
Monitoring for the onset of circulatory shock in a wounded soldier on the battlefield is typically performed by measurement of arterial blood pressure (mean, systolic, diastolic), arterial oxygen saturation (oximetry), or simple auscultation of the pulse (rate and character).
Shock is typically recognized by non-specific signs and subjective symptoms such as: cold clammy skin, pallor, weak thready pulse, unstable vital signs, and diminished mentation. Unfortunately, these signs are imprecise, subjective, and inconsistent.
Therefore, a definition based on the absence or presence of hypotension can be misleading since it does not represent the underlying problem of or the solution to hemorrhagic shock.
The resulting challenge is that shock is easily diagnosed in late stages when therapy is ineffective while early diagnosis is difficult because shock is first recognized by imprecise signs and subjective symptoms.
Description
The near-infrared diffuse optical spectroscopy (NIR-DOS) developed at the Beckman Laser Institute,UC Irvine, has ability to analyzes tissue regions deeper below the skin surface and reports on larger tissue volumes in muscle and brain.
The FDPM DOS instrument generates harmless amounts of low-level non-ionizing NIR ligh. The DOS probe will be applied to the selected sites with standard of care procedure. The measurement will be repeated several times to monitor the physiology. The monitoring will continue intermittently during the period of the experiment.
Study Design
Observational Model: Case-Only, Time Perspective: Prospective
Conditions
Hemorrhagic Shock
Intervention
NIR/DOS
Location
Beckman Laser Institute,University of California, Irvine
Irvine
California
United States
92612
Status
Enrolling by invitation
Source
University of California, Irvine
Results (where available)
Links
- Source: http://clinicaltrials.gov/show/NCT00581204
- Information obtained from ClinicalTrials.gov on July 15, 2010
Medical and Biotech [MESH] Definitions
Dengue Hemorrhagic Fever
A distinct and virulent form of DENGUE characterized by thrombocytopenia and hemoconcentration (grades I and II) and distinguished by a positive tourniquet test. When accompanied by circulatory failure and shock (grades III and IV), it is called dengue shock syndrome. (From Dorland, 28th ed)
Exsanguination
Rapid and extreme blood loss leading to HEMORRHAGIC SHOCK.
Shock, Hemorrhagic
Acute hemorrhage or excessive fluid loss resulting in HYPOVOLEMIA.
Hemorrhagic Fevers, Viral
A group of viral diseases of diverse etiology but having many similar clinical characteristics; increased capillary permeability, leukopenia, and thrombocytopenia are common to all. Hemorrhagic fevers are characterized by sudden onset, fever, headache, generalized myalgia, backache, conjunctivitis, and severe prostration, followed by various hemorrhagic symptoms. Hemorrhagic fever with kidney involvement is HEMORRHAGIC FEVER WITH RENAL SYNDROME.
Hsp40 Heat-shock Proteins
A family of heat-shock proteins that contain a 70 amino-acid consensus sequence known as the J domain. The J domain of HSP40 heat shock proteins interacts with HSP70 HEAT-SHOCK PROTEINS. HSP40 heat-shock proteins play a role in regulating the ADENOSINE TRIPHOSPHATASES activity of HSP70 heat-shock proteins.
Clinical Trials
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PubMed Articles
Vagal nerve stimulation modulates gut injury and lung permeability in trauma-hemorrhagic shock.
Hemorrhagic shock is known to disrupt the gut barrier leading to end-organ dysfunction. The vagus nerve can inhibit detrimental immune responses that contribute to organ damage in hemorrhagic shock. T...
ABSTRACT: BACKGROUND: Hemorrhagic shock followed by resuscitation stimulates an inflammatory response. This study tests the hypothesis that treatment with fish oil will attenuate inflammatory respons...
Nitric oxide modulates biphasic changes of isolated lymphatic contraction in hemorrhagic shock rats.
The aim of the present study was to investigate the changes of lymphatic contraction after hemorrhagic shock in vitro and the underlying role of nitric oxide (NO). Rat thoracic duct segments were isol...
BACKGROUND:: Hypertonic saline solutions in combination with colloids may have some applications in critically ill patients. Our aim was to examine the effects of small volumes (0.7-1 mL/kg intravenou...
In this study, hemoglobin vesicle (HbV), a type of artificial oxygen carrier, was infused in a hemorrhagic shock model, and the findings were compared with those of red blood cell (RBC) transfusion to...
