Thoracic, peripheral, and cerebral volume, circulatory and pressure responses to PEEP during simulated hemorrhage in a pig model: a case study

Leslie D. Montgomery; Richard W. Montgomery; Michael Bodo; Richard T. Mahon; Frederick J. Pearce

doi:10.2478/joeb-2021-0013

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Thoracic, peripheral, and cerebral volume, circulatory and pressure responses to PEEP during simulated hemorrhage in a pig model: a case study

Journal of Electrical Bioimpedance

Volume 12 (2021): Issue 1 (January 2021)

By: Leslie D. Montgomery, Richard W. Montgomery, Michael Bodo, Richard T. Mahon and Frederick J. Pearce

Open Access

|Dec 2021

Figures & Tables

Mean arterial pressure (SAP) during the recoding and challenges (bleeding and PEEP). Y-axis is in mmHg; X-axis is clock time. EIS recording stated at 13.43.

Mean pulmonary arterial pressure (PA-M) and simulated hemorrhage (VOLOUT) vs elapsed time. PA-M is not affected by the amount of bleeding prior to the first bleeding. However, PEEP produces an increase in PA-M following the first and second bleed periods.

Normalized intravascular (nVblood), cellular (nVcellular) and interstitial (nVinterstital) calf compartment volumes vs. elapsed time.

Fluid transfer in and out of the cells (Fc), interstitial space (Fi), and intravascular compartment (Fb) vs. elapsed time.

Mean pulmonary arterial pressure (PA-M) and calf percent blood flow (%BF) vs. elapsed time.

Mean pulmonary arterial pressure [PA-M], time of arterial blood inflow (TIN), and time of venous outflow (TOUT) vs. elapsed time.

Systemic arterial pressure (SAP) and continuous cardiac output (CCO) vs. elapsed time.

Mean pulmonary arterial pressure (PA-M), stroke volume (SV), and heart rate (HR) vs. elapsed time.

Mean pulmonary arterial pressure (PA-M), stroke volume (SV), and mean cardiac output (CCO) vs. elapsed time.

Mean pulmonary arterial pressure (PA-M), stroke volume (SV), and time of venous outflow (TOUT) vs. elapsed time.

Continuous analog parameters (as a strip chart) vs. time. CBF AR is active.

Continuous analog parameters (plotted as a strip chart) vs. time. CBF AR is passive.

Intracranial pressure (ICP), systemic arterial pressure (SAP), REG integral (REG integral), PRx, and REGx plotted as analog strip chart vs. time. The first number of PRx and REGx calculations starts at 300 sec of the original signal. Pig CBF 9, file 13:32, time window 96.52 min.

Phases of shock. The shock phases defined as compensatory represent the removal of 50% and 100% of peak shed blood volume (3% of body weight). Shock phases defined as decompensatory represent the return of 20 and 75% of the shed blood volume [58].

Summary of CBF AR changes_

Challenge	SAP	CFa	CFm	REG1d	CBF	LDF	ICP	CVP	PAP	CO2	pO2
iso-prop
transit	+	-	-	-	-	+	-	-	+/-	0	-
PEEP 10	-	+	-	+	+	-	+	-	0	+	-
PEEP 15	-	+	-	+	+/-	+	+	-	0	+	-
PEEP 20	-	+	-	+	+/-	+	+	-	-	+	-
hemorrhage 1	-	+	-	+	+	+	-/+	+	+	-	-/+
PEEP 10	0	0	-/+	+	0	0	+	-	-	+	-
PEEP 15	-	-/+	-/+	+	+	0	+	-	-	+	-
PEEP 20	-	-/+	-/+	+	-/+	-/+	+	-	+	+	-
CO₂ inhalation	+	0	0	0	+	0	+	0	-	+	-
hemorrhage 2	-	+	+/-	+	-	0	-	+	+	0	+/0
PEEP 10	0	0	+	-	+	0	+	-	-	+	-
PEEP 15	+	-	+	-	+	0	+	+	-	+	-
PEEP 20	-/+	-	-	-	+	+	+	+	-	+	-
hemorrhage 3	-	+	-	+	+	0	-	-	-	+	0
PEEP 10	+	0	0	0	0	0	+	+/-	+	+	+
lethal
bleeding	-	+/-	-	+/-	-	-	-	-/+	+/-	-/+	+/-

CBF AR active		7	1	9	4	3	6	3	4	5	3

Percent changes of mean ICP and REG integral during 15 and 20 cmH2O PEEPs before first (1) and after first bleedings (2), and after second bleeding (3)_ Values are in percentage of their own baseline_ Measurement was made at the highest values_ Note that after 2nd bleeding REG values are negative, indicating that CBF AR is passive_

	ICP		REG
	15 cm H₂O	20 cm H₂O	15 cm H₂O	20 cm H₂O
1	132	148	15	31
2	133	148	28	40
3	74	48	-19	-41

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DOI: https://doi.org/10.2478/joeb-2021-0013 | Journal eISSN: 1891-5469

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Language: English

Page range: 103 - 116

Submitted on: Oct 7, 2021

Published on: Dec 27, 2021

Published by: University of Oslo

In partnership with: Paradigm Publishing Services

Publication frequency: 1 issue per year

Keywords:

Bioimpedance,

electrical impedance spectroscopy,

systemic arterial pressure,

pulmonary arterial pressure,

PEEP,

bleeding,

cerebrovascular reactivity,

REG,

carotid flow,

ICP,

pig

Related subjects:

Engineering,

Bioengineering and biomedical engineering,

Biomedical electronics,

Life sciences,

Biophysics,

Medicine,

Biomedical engineering,

Physics,

Spectroscopy and metrology

© 2021 Leslie D. Montgomery, Richard W. Montgomery, Michael Bodo, Richard T. Mahon, Frederick J. Pearce, published by University of Oslo
This work is licensed under the Creative Commons Attribution 4.0 License.

Volume 12 (2021): Issue 1 (January 2021)

Thoracic, peripheral, and cerebral volume, circulatory and pressure responses to PEEP during simulated hemorrhage in a pig model: a case study

Figures & Tables

Figure 1

Figure 2

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Figure 7

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Figure 9

Figure 10

Figure 11

Figure 12

Figure 13

Figure 14

Summary of CBF AR changes_

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