Document Detail

Lower body negative pressure as a model to study progression to acute hemorrhagic shock in humans.
MedLine Citation:
PMID:  15016789     Owner:  NLM     Status:  MEDLINE    
Hemorrhage is a leading cause of death in both civilian and battlefield trauma. Survival rates increase when victims requiring immediate intervention are correctly identified in a mass-casualty situation, but methods of prioritizing casualties based on current triage algorithms are severely limited. Development of effective procedures to predict the magnitude of hemorrhage and the likelihood for progression to hemorrhagic shock must necessarily be based on carefully controlled human experimentation, but controlled study of severe hemorrhage in humans is not possible. It may be possible to simulate hemorrhage, as many of the physiological compensations to acute hemorrhage can be mimicked in the laboratory by applying negative pressure to the lower extremities. Lower body negative pressure (LBNP) sequesters blood from the thorax into dependent regions of the pelvis and legs, effectively decreasing central blood volume in a similar fashion as acute hemorrhage. In this review, we compare physiological responses to hemorrhage and LBNP with particular emphasis on cardiovascular compensations that both share in common. Through evaluation of animal and human data, we present evidence that supports the hypothesis that LBNP, and resulting volume sequestration, is an effective technique to study physiological responses and mechanisms associated with acute hemorrhage in humans. Such experiments could lead to clinical algorithms that identify bleeding victims who will likely progress to hemorrhagic shock and require lifesaving intervention(s).
William H Cooke; Kathy L Ryan; Victor A Convertino
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Review    
Journal Detail:
Title:  Journal of applied physiology (Bethesda, Md. : 1985)     Volume:  96     ISSN:  8750-7587     ISO Abbreviation:  J. Appl. Physiol.     Publication Date:  2004 Apr 
Date Detail:
Created Date:  2004-03-12     Completed Date:  2004-10-13     Revised Date:  2013-09-26    
Medline Journal Info:
Nlm Unique ID:  8502536     Medline TA:  J Appl Physiol (1985)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1249-61     Citation Subset:  IM    
US Army Institute of Surgical Research, Fort Sam Houston, TX 78234-6315, USA.
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MeSH Terms
Acute Disease
Disease Progression
Heart Rate
Hemorrhage / blood,  complications*,  physiopathology*
Lower Body Negative Pressure*
Neurotransmitter Agents / blood
Shock, Hemorrhagic / etiology*,  physiopathology
Reg. No./Substance:
0/Neurotransmitter Agents

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