Browse > Article

A New Shock Index for Predicting Survival of Rats with Hemorrhagic Shock Using Perfusion and Lactate Concentration Ratio  

Choi, Jae-Lim (Graduate Program in Biomedical Engineering, Yonsei University)
Nam, Ki-Chang (Clinical Trials Center for Medical Devices, Severance Hospital)
Kwon, Min-Kyung (Brain Korea 21 Project for Medical Science, Yonsei University)
Jang, Kyung-Hwan (Graduate Program in Biomedical Engineering, Yonsei University)
Kim, Deok-Won (Dept. of Medical Engineering, Yonsei Uinversity College of Medicine)
Publication Information
Journal of the Institute of Electronics Engineers of Korea SC / v.48, no.4, 2011 , pp. 1-9 More about this Journal
Abstract
Hemorrhagic shock is a clinically widespread syndrome characterized by inadequate oxygenation and supply. It is important to diagnose hemorrhagic shock in its early stage for improving treatment effects and survival rate. However, an accurate diagnosis and treatment could be delayed in the early stage of hemorrhagic shock by evaluating only vital signs such as heart rate and blood pressure. There have been many studies for the early diagnosis of hemorrhagic shock, reporting that lactate concentration and perfusion were useful variables for tissue hypoxia and metabolic acidosis. In this study, we measured both perfusion using a laser Doppler flowmeter and lactate concentration from the volume controlled hemorrhagic shock using rats. We also proposed a new shock index which was calculated by dividing lactate concentration by perfusion for early diagnosis. As a result of the survival prediction by the proposed index with the receiver operating characteristic curve method, the sensitivity, specificity, and accuracy of survival were 90.0, 96.7 and 94.0%, respectively. The proposed index showed the fastest significant difference among the other parameters such as blood pressure and heart rate. It could offer early diagnosis and effective treatment for human hemorrhagic shock if it is applicable to humans.
Keywords
Hemorrhagic shock; Lactate concentration; Perfusion; Rat; Laser Doppler;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 이탁형, 이주형, 최재림, 양동인, 김덕원, "출혈성 쇼크를 일으킨 흰쥐에서 선형회귀 분석모델을 이용한 출혈량 추정," 전자공학회논문지, 제47권 SC편, 제1호, 56-61쪽, 2010년, 1월
2 National Research Council (US) Committee for the Update of the Guide for the Care and Use of Laboratory Animals, Guide for care and use of laboratory animals, 8th edition, National Academies Press (US), pp. 1-220, 2011.
3 A. Takasu and T. Sakamoto, "Effect of induction rate for mild hypothermia on survival time during uncontrolled hemorrhagic shock in rats," J Trauma, Vol. 61, no. 6, pp. 1330-1335, Dec, 2006.   DOI
4 M. J. Leahy, F. F. M. de Mul, G. E. Nilsson and R. Maniewski, "Principles and practice of the laser-Doppler perfusion techique," Technol Health Care, Vol.7, no. 2-3, pp. 143-162, 1999.
5 K. H. Diehl, R. Hull, D. Morton, R. Pfister, Y. Rabemampianina, D. Smith, J. M. Vidal and C van de Vorstenbosch, "A good practice guide to the administration of substances and removal of blood, including routes and volumes," J Appl Toxicol, Vol. 21, no. 1, pp. 15-23, Jan-Feb, 2001   DOI   ScienceOn
6 C. Goodrich, "Endpoint of resuscitation: what should we be monitoring?," AACN advanced Critical Care, Vol. 17, no. 3, pp. 306-316, July, 2006.   DOI   ScienceOn
7 J. L. Choi, D. W. Kim and Y. S. Park, "Prediction of blood loss in rats during fixed volume hemorrhage using a regression model," Shock, Vol. 33, Suppl 1, pp. 14, June, 2010.   DOI   ScienceOn
8 J. Markovchick and T. Pons, Emergency medicine secrets, 4th edition, Philadelphia, pp. 28-32, 2006.
9 J. H. Lee, T. K. Lee, S. W. Chung, H. W. No and D. W. Kim, "Changes in heart rate and heart rate variability induced by hemorrhagic shock in rats shock," Shock, Vol. 31 Suppl 1, pp. 21, June, 2009.   DOI   ScienceOn
10 D. W. Kim, J. L. Choi and Y. S. Park, "Survival prediction in rats with fixed-volum hemorrhage using a logistic regression equation," Shock, Vol. 33, Suppl 1, pp. 14, June, 2010.   DOI   ScienceOn
11 M. Wilson, D. P. Davis and R. Coimbra, "Diagnosis and monitoring of hemorrhagic shock during the initial resuscitation of multiple trauma patients: a review," J Emerg Med, Vol. 24, pp. 413-422, May, 2003.   DOI   ScienceOn
12 D. Abramson, T. M. Scalea, R. Hitchcock, S. Z. Trooskin, S. M. Henry and J. Greenspan, "Latate clearance and survival following injury", J Trauma, Vol. 35, no. 4, pp. 584-588, Oct, 1993.   DOI   ScienceOn
13 R. P Dutton, "Current concepts in hemorrhagic shock," Anesthesiology Clin, Vol. 25, no. 1, pp. 23-34, Mar, 2007.   DOI   ScienceOn
14 M. J. Vandromme, R. L. Griffin, J. A. Weinberg, L. W. Rue III and J. D. Kerby, "Lactate is a better predictor than systolic blood pressure for determining blood requirement and mortality: Could prehospital measures improve trauma triage?," J Am Coll Surg, Vol. 210, no. 5, pp. 861-867, May, 2010.   DOI   ScienceOn
15 A. Lima and J. Bakker, "Noninvasive monitoring of peripheral perfusion," Intensive Care Med, Vol. 31, no. 10 pp. 1316-1326, Oct, 2005.   DOI