Convertino Victor A, Snider Eric J, Hernandez-Torres Sofia I, Collier James P, Eaton Samantha K, Holmes David R, Haider Clifton R, Salinas Jose
Battlefield Health & Trauma Center for Human Integrative Physiology, US Army Institute of Surgical Research, JBSA Fort Sam Houston, San Antonio, TX 78234, USA.
Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.
Bioengineering (Basel). 2023 Oct 20;10(10):1226. doi: 10.3390/bioengineering10101226.
Since hemorrhage is a leading cause of preventable death in both civilian and military settings, the development of advanced decision support monitoring capabilities is necessary to promote improved clinical outcomes. The emergence of lower body negative pressure (LBNP) has provided a bioengineering technology for inducing progressive reductions in central blood volume shown to be accurate as a model for the study of the early compensatory stages of hemorrhage. In this context, the specific aim of this study was to provide for the first time a systematic technical evaluation to meet a commonly accepted engineering standard based on the FDA-recognized Standard for Assessing Credibility of Modeling through Verification and Validation (V&V) for Medical Devices (ASME standard V&V 40) specifically highlighting LBNP as a valuable resource for the safe study of hemorrhage physiology in humans. As an experimental tool, evidence is presented that LBNP is credible, repeatable, and validated as an analog for the study of human hemorrhage physiology compared to actual blood loss. The LBNP tool can promote the testing and development of advanced monitoring algorithms and evaluating wearable sensors with the goal of improving clinical outcomes during use in emergency medical settings.
由于出血是导致平民和军人可预防死亡的主要原因,因此开发先进的决策支持监测能力对于改善临床结果至关重要。下体负压(LBNP)的出现提供了一种生物工程技术,可诱导中心血容量逐渐减少,已证明其作为出血早期代偿阶段研究模型是准确的。在此背景下,本研究的具体目标是首次基于FDA认可的《通过验证和确认评估医疗器械建模可信度标准》(ASME标准V&V 40)进行系统的技术评估,以符合普遍认可的工程标准,特别强调LBNP是安全研究人类出血生理学的宝贵资源。作为一种实验工具,有证据表明,与实际失血相比,LBNP作为研究人类出血生理学的模拟手段是可信、可重复且经过验证的。LBNP工具可促进先进监测算法的测试和开发,并评估可穿戴传感器,目标是在紧急医疗环境中使用时改善临床结果。