HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Free Full Text (PDF) Free Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (29) Citing Articles via Google Scholar Google Scholar Articles by Cooke, W. H. Articles by Convertino, V. A. Search for Related Content PubMed PubMed Citation Articles by Cooke, W. H. Articles by Convertino, V. A.

INVITED REVIEW

Lower body negative pressure as a model to study progression to acute hemorrhagic shock in humans

US Army Institute of Surgical Research, Fort Sam Houston, Texas 78234

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).

combat casualty care; simulated hemorrhage; central hypovolemia; autonomic cardiovascular regulation

This article has been cited by other articles:

				M. Lindenberger, H. Olsen, and T. Lanne Lower capacitance response and capillary fluid absorption in women to defend central blood volume in response to acute hypovolemic circulatory stress Am J Physiol Heart Circ Physiol, August 1, 2008; 295(2): H867 - H873. [Abstract] [Full Text] [PDF]

				K. L. Ryan, W. H. Cooke, C. A. Rickards, K. G. Lurie, and V. A. Convertino Breathing through an inspiratory threshold device improves stroke volume during central hypovolemia in humans J Appl Physiol, May 1, 2008; 104(5): 1402 - 1409. [Abstract] [Full Text] [PDF]

				B. R. Soller, Y. Yang, O. O. Soyemi, K. L. Ryan, C. A. Rickards, J. M. Walz, S. O. Heard, and V. A. Convertino Noninvasively determined muscle oxygen saturation is an early indicator of central hypovolemia in humans J Appl Physiol, February 1, 2008; 104(2): 475 - 481. [Abstract] [Full Text] [PDF]

				M. Lindenberger and T. Lanne Decreased capillary filtration but maintained venous compliance in the lower limb of aging women Am J Physiol Heart Circ Physiol, December 1, 2007; 293(6): H3568 - H3574. [Abstract] [Full Text] [PDF]

				C. A. Rickards, K. L. Ryan, W. H. Cooke, K. G. Lurie, and V. A. Convertino Inspiratory resistance delays the reporting of symptoms with central hypovolemia: association with cerebral blood flow Am J Physiol Regulatory Integrative Comp Physiol, July 1, 2007; 293(1): R243 - R250. [Abstract] [Full Text] [PDF]

				I. Taneja, C. Moran, M. S. Medow, J. L. Glover, L. D. Montgomery, and J. M. Stewart Differential effects of lower body negative pressure and upright tilt on splanchnic blood volume Am J Physiol Heart Circ Physiol, March 1, 2007; 292(3): H1420 - H1426. [Abstract] [Full Text] [PDF]

				M. Lindenberger and T. Lanne Sex-related effects on venous compliance and capillary filtration in the lower limb Am J Physiol Regulatory Integrative Comp Physiol, February 1, 2007; 292(2): R852 - R859. [Abstract] [Full Text] [PDF]

				M. Ichinose, M. Saito, N. Fujii, N. Kondo, and T. Nishiyasu Modulation of the control of muscle sympathetic nerve activity during severe orthostatic stress J. Physiol., November 1, 2006; 576(3): 947 - 958. [Abstract] [Full Text] [PDF]