Closed-loop algorithms and resuscitation systems are being developed to control IV infusion rate during early resuscitation of hypovolemia. Although several different physiologic variables have been suggested as an endpoint to guide fluid therapy, blood pressure remains the most used variable for the initial assessment of hemorrhagic shock and the treatment response to volume loading. Closed-lo...

During acute altitude exposure tachycardia increases cardiac output (Q) thus preserving systemic O2 delivery. Within days of acclimatization, however, Q normalizes following an unexplained reduction in stroke volume (SV). To investigate whether the altitude-mediated reduction in plasma volume (PV) and hence central blood volume (CBV) is the underlying mechanism we increased/decreased CBV by mea...

We present a classifier for use as a decision assist tool to identify a hypovolemic state in trauma patients during helicopter transport to a hospital, when reliable acquisition of vital-sign data may be difficult. The decision tool uses basic vital-sign variables as input into linear classifiers, which are then combined into an ensemble classifier. The classifier identifies hypovolemic patient...

Twelve patients with the clinical features of shock following acute myocardial infarction were treated with low molecular weight dextran (LMWD) as a plasma volume expander. Two of the patients had elevated central venous pressures (CVP), and neither responded favorably to plasma volume expansion. The remaining 10 patients had CVPs under 7 mm Hg prior to dextran infusion; five survived. Each sur...

We previously demonstrated that diuretic-induced hypovolemia resulted in an enhanced baroreflex-mediated increase in integrated muscle sympathetic nerve activity (MSNA) and vasomotor tone during lower body negative pressure (LBNP) (Am J Physiol Heart Circ Physiol 282: H645-H655, 2002). The purpose of this study was to perform a retrospective analysis of these data and examine the ability of rel...

The selective regulation of total peripheral circulation in hypovolemic crisis offers a unique approach for treating and preventing hemorrhagic shock. Ideally, such a therapeutic intervention would require targeting of the striated muscle vascular beds without altering the vascular resistance in vital organ vascular beds. We discovered that a combination of cannabinoid receptor agonist, THC (Δ-...

Introduction Hemorrhagic shock resuscitation aims at maintaining tissue perfusion while waiting for hemorrhage control. Fluid resuscitation remains the first line therapy to improve tissue perfusion but a vasoconstrictor (most often norepinephrine) may be associated to stabilize the mean arterial pressure (MAP) level and avoid hemodilution while waiting for transfusion. However, the arteriolar ...

Introduction In the brain-dead organ donors a number of hormonal changes occurs, reflecting anterior and posterior pituitary failure. There is an early development of diabetes insipidus in almost 80% of brain-dead organ donors, characterized by inappropriate diuresis, severe hypovolemia, hyperosmolality, and electrolyte abnormalities, such as hypernatremia and hyperchloremia. Hypernatremia and ...