Department of Chemical and Biomolecular Engineering, Institute for Medicine and Engineering, University of Pennsylvania, Philadelphia, Pennsylvania.
Department of Trauma Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
Wiley Interdiscip Rev Syst Biol Med. 2018 Jul;10(4):e1418. doi: 10.1002/wsbm.1418. Epub 2018 Feb 27.
Trauma with hypovolemic shock is an extreme pathological state that challenges the body to maintain blood pressure and oxygenation in the face of hemorrhagic blood loss. In conjunction with surgical actions and transfusion therapy, survival requires the patient's blood to maintain hemostasis to stop bleeding. The physics of the problem are multiscale: (a) the systemic circulation sets the global blood pressure in response to blood loss and resuscitation therapy, (b) local tissue perfusion is altered by localized vasoregulatory mechanisms and bleeding, and (c) altered blood and vessel biology resulting from the trauma as well as local hemodynamics control the assembly of clotting components at the site of injury. Building upon ongoing modeling efforts to simulate arterial or venous thrombosis in a diseased vasculature, computer simulation of trauma-induced coagulopathy is an emerging approach to understand patient risk and predict response. Despite uncertainties in quantifying the patient's dynamic injury burden, multiscale systems biology may help link blood biochemistry at the molecular level to multiorgan responses in the bleeding patient. As an important goal of systems modeling, establishing early metrics of a patient's high-dimensional trajectory may help guide transfusion therapy or warn of subsequent later stage bleeding or thrombotic risks. This article is categorized under: Analytical and Computational Methods > Computational Methods Biological Mechanisms > Regulatory Biology Models of Systems Properties and Processes > Mechanistic Models.
创伤性低血容量性休克是一种极端的病理状态，使机体在面对失血性失血时，需要维持血压和氧合。结合手术操作和输血治疗，患者的血液需要保持止血以停止出血，以确保生存。这个问题的物理学是多尺度的：（a）全身循环根据失血和复苏治疗来设定全局血压，（b）局部组织灌注受到局部血管调节机制和出血的影响，（c）创伤导致的血液和血管生物学的改变以及局部血液动力学控制着凝血成分在损伤部位的组装。在对疾病血管中动脉或静脉血栓形成进行模拟的持续建模工作的基础上，创伤性凝血病的计算机模拟是一种新兴的方法，可以帮助理解患者的风险并预测反应。尽管在量化患者动态损伤负担方面存在不确定性，但多尺度系统生物学可能有助于将血液生物化学与出血患者的多器官反应联系起来。作为系统建模的一个重要目标，建立患者高维轨迹的早期指标可能有助于指导输血治疗或预警随后的晚期出血或血栓形成风险。本文属于以下类别：分析和计算方法>计算方法生物学机制>调节生物学模型系统特性和过程>机制模型。
