Development of physiologically-based mathematical models for hemostatic resuscitation in trauma – Bio-mathematical models for trauma resuscitation

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Authors
  1. Peng, H.
  2. Sweeny, A.
Corporate Authors
Defence Research and Development Canada, Toronto Research Centre , Toronto ON (CAN)
Abstract
Bleeding is the leading cause of preventable death on the battlefield. More recent practices emphasise hemostatic resuscitation through early administration of ratio-based blood products and coagulation factor concentrates for massive hemorrhage management for combat casualties. Alternatively, there is evidence for individualized goal-directed patient treatment with coagulation factors (e.g., fibrinogen concentrate) in severe trauma patients and to abstain from the use of fresh frozen plasma. The combined viscoelastic hemostatic tests and physiologically-based mathematical models would enable optimal treatment for individual trauma patients. The report describes our efforts to develop such a model that can simulate hemostatic resuscitation in particular fibrinogen administration in trauma. The model integrated an existing blood coagulation model and several hemodynamic modules to account for hemostasis and physiological changes in trauma into a whole-body physiologically-based pharmacokinetic model adapted for fibrinogen. The model went through a number of refinements and the current version was able to simulate pharmacokinetics and coagulation effects of fibrinogen in a number of clinical studies including our own which involved different therapeutic regiments. Together with experimental hemostatic assays the model may be a useful tool to support and even guide hemostatic resuscitation in trauma.

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Keywords
Mathematical models;hemostatic resuscitation;fibrinogen;trauma
Report Number
DRDC-RDDC-2016-R225 — Scientific Report
Date of publication
01 Nov 2016
Number of Pages
72
DSTKIM No
CA044538
CANDIS No
805098
Format(s):
Electronic Document(PDF)

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