Compensatory Reserve Index Can Aid in Early Shock Detection

EARLY SHOCK DETECTION Convertino VA, Howard JT, Hinojosa-Laborde C. Individual-specific, beat-to-beat trending of significant human blood loss: The compensatory reserve. Shock. Jan. 6, 2015. [Epub ahead of print.] Hemorrhagic shock is the leading cause of death in trauma. The challenge is detecting shock early enough to intervene clinically. The human body is masterful at compensating with a variety of seemingly undetectable mechanisms, such as autonomic activity, vasoconstriction, increased stroke volume, improved cardiac filling and more efficient breathing. So by the time we see alterations in vital sign metrics, the patient may have lost as much as a third of their circulating blood volume. What if there was a way to measure accurate beat-to-beat assessment of hemodynamics? Background: Former NASA physiologist and EMS 10 award-winner Victor Convertino, PhD, who now works in the United States Army Institute of Surgical Research, has been working toward being able to better and more accurately detect when the body may be going into hemorrhagic shock. After years of not finding any helpful patterns in the metrics, Convertino and his team looked at arterial waveforms, finding that they’re made up of two distinct waves: the ejected wave (the contraction of the heart) and the reflected wave (pressure being reflected back from the arterial vasculature). With the help of robotics experts, Convertino and his team were able to use self-learning algorithms to learn from an indi...
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Resuscitation & Shock Special Topics Research Columns Patient Care Source Type: news