Hemorrhage Module

Our computational models replicate both human physiology and pathophysiology, here we describe our hemorrhage scenarios simulations and results based upon quantified blood loss. The AIBODY organism measures both the individual parameters and accounts for the systemic interactions with progressive blood loss.

Our hemorrhage simulations show progressive, quantified blood-loss from compensated hypovolaemia to shock and outputs real time data for cardiorespiratory variables (HR, Systolic blood pressure, RR). We validate our model against the shock index metric. Shock index is defined as systolic blood pressure divided by heart rate.

The current ATLS shock classification used does not represent the majority of trauma scenarios in real life. A recent retrospective study of 36,000 patients showed that only 9.3% of patients were adequately classified according to ATLS. In general the shock index rises earlier than isolated vital sign cut offs in patients with shock and individual vital signs fail to represent the severity of hypovolaemia and shock in major trauma.

Tibial Hemorrhage

Simulates peripheral arterial bleeding with gradual shock progression.

Blood Loss	Parameter	Reference Range	Observed Value	Reference
500 mL	Shock Index	< 0.7	0.68	Koch E, Lovett S, Nghiem T, Riggs RA, Rech MA. Shock index in the emergency department: utility and limitations. Open Access Emerg Med. 2019 Aug 14;11:179–199.
1000 mL	Shock Index	0.7 – 1.0	0.81
1750 mL	Shock Index	1.0 – 1.4	1.16
2500 mL	Shock Index	> 1.4	1.8

Femoral Hemorrhage

Models rapid blood loss from a major limb artery and early hypotension onset.

Blood Loss	Parameter	Reference Range	Observed Value	Reference
500 mL	Shock Index	< 0.7	0.68	Koch E, Lovett S, Nghiem T, Riggs RA, Rech MA. Shock index in the emergency department: utility and limitations. Open Access Emerg Med. 2019 Aug 14;11:179–199.
1000 mL	Shock Index	0.7 - 1.0	0.79
1750 mL	Shock Index	1.0 - 1.4	1.16
2500 mL	Shock Index	> 1.4	1.79

Aortic Hemorrhage

Central vessel rupture causing immediate, life-threatening systemic collapse.

Blood Loss	Parameter	Reference Range	Observed Value	Reference
500 mL	Shock Index	< 0.7	0.68	Koch E, Lovett S, Nghiem T, Riggs RA, Rech MA. Shock index in the emergency department: utility and limitations. Open Access Emerg Med. 2019 Aug 14;11:179–199.
1000 mL	Shock Index	0.7 - 1.0	0.78
1750 mL	Shock Index	1.0 - 1.4	1.15
2500 mL	Shock Index	> 1.4	1.78

Ventricular Hemorrhage

Represents internal cardiac bleeding with steep drop in output and perfusion.

Blood Loss	Parameter	Reference Range	Observed Value	Deviation %	Reference
500 mL	Shock Index	< 0.7	0.71	1.1	Koch E, Lovett S, Nghiem T, Riggs RA, Rech MA. Shock index in the emergency department: utility and limitations. Open Access Emerg Med. 2019 Aug 14;11:179–199.
1000 mL	Shock Index	0.7 - 1.0	0.78	0
1750 mL	Shock Index	1.0 - 1.4	1.16	0
2500 mL	Shock Index	> 1.4	1.84	0

Carotid Hemorrhage

High-risk neck vessel injury producing distinct cerebral and systemic shock dynamics.

Blood Loss	Parameter	Reference Range	Observed Value	Reference
500 mL	Shock Index	< 0.7	0.67	Koch E, Lovett S, Nghiem T, Riggs RA, Rech MA. Shock index in the emergency department: utility and limitations. Open Access Emerg Med. 2019 Aug 14;11:179–199.
1000 mL	Shock Index	0.7 - 1.0	0.77
1750 mL	Shock Index	1.0 - 1.4	1.12
2500 mL	Shock Index	> 1.4	1.73