TraumAID Current Projects

This page describes the major directions TraumAID is taking and where we expect they will lead.

  • TraumaTIQ - On-line Critique for TraumAID
  • Acute Hemorrhage Model - Predicts the evolving condition of a victim of massive blood loss
  • TrauMAP - Integrating Anatomy and Physiology
  • PPathSCAN - Assessing Penetrating Injuries Probabilistically
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    TraumaTIQ

    The effective communication of information is an important concern in the design of an expert consultation system. Several researchers have chosen to adopt a critiquing model, in which the system evaluates and reacts to a solution proposed by the user rather than presenting its own solution. TraumaTIQ embodies an architecture for a critiquing system that functions in real-time, during the process of developing and executing a management plan in time-critical situations. The architecture is able to take account of and reason about multiple, interacting goals and to identify critical errors in the proposed management plan. This architecture is being implemented as part of the TraumAID system for the management of patients with severe injuries.

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    Acute Hemorrhage Modeling

    Computer modeling is swiftly becoming a popular tool of the medical profession for use in a variety of capacities. While several models exist which attempt to portray the evolution over time of the cardiovascular system, they are based on steady-state conditions, or hemorrhage over long-term periods (days to weeks), or animal studies. Here, the human cardiovascular system is perturbed via the condition of acute hemorrhage, wherein a significant amount of blood is lost from the circulatory system over a short period of time (minutes to hours).

    Method of Modeling

    Initially, we explored the possibility of using a continuous flow model for representing the human cardiovascular (CV) system undergoing acute hemorrhage. We discovered that while this approach provided a gross overview of systemic functioning, it did not provide sufficient detail of specific physiologic parameter variations, nor did it allow examination of certain physiologic functions critical in massive hemorrhage.

    The next modeling technique we considered was a pulsatile, beat-to-beat method. This model is based upon time-varying, ventricular compliances which lead to a pulsatile nature. Using an electrical analog of resistors, capacitors, and diodes, the model represents blood flow through a compartmentalized CV system of eight quadrants: systemic arterial and venous, pulmonary arterial and venous, left and right atria and ventricles. A set of eight equations, solved simultaneously, yields pressure changes for each of the eight compartments over time.

    As a body experiences hemorrhage, it responds in phases, depending on how much blood has been lost. For loss of 10-15%, the baroreflex controls physiologic response and maintains mean systemic arterial blood pressure by regulating vascular resistance and compliance, and heart rate. For loss of 15- 30%, the vagovagal effect dominates, reversing the above trend by decreasing heart rate and resistance, and increasing compliance. For loss exceeding 30%, the vagovagal effect subsides, and once again, trends reverse. Heart rate and resistance increase, and compliance decreases.

    The acute hemorrhage model performs well for losses up to 30% of initial blood volume. Since experimental data is sparce for losses greater than that, more research on physiologic response at that level of hemorrhage is required before the model can be designed to accomodate such extreme hypovolemia.

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    TrauMAP: Trauma Modeling of Anatomy and Physiology

    VR systems require both realistic geometric and behavioral modeling. This means that objects in a virtual environment must look real, both in their visual presentation and their behavior. Systems that aim to model anatomy realistically often focus on geometric aspects of the problem, such as accurately modeling shape, with lesser emphasis, if any, on the functional relationships among anatomical parts. Physiological simulations (in the form of differential equations), on the other hand, focus on functional relationships, with less consideration for the physical presence of objects and the physical space in which the processes take place.

    TrauMAP models some immediate consequences of penetrating trauma (gunshot and stab wounds). The system ties together the spatial (geometric) properties of an anatomical object with the object's role as part of the appropriate physiological system. By associating the physical presence of a substance or object with its functional role, TrauMAP can infer simple effects of a structural change on physiology, and vice versa. This can be useful for detecting situations where independent physiological systems become dependent because they are physically adjacent to one another. TrauMAP ultimately will use knowledge of the physical dependencies of physiological processes to infer when more detailed physiological models are necessary (those that incorporate knowledge about spatial concerns).

    We represent anatomical parts with volumetric, viscoelastic elements (physics-based, deformable body dynamics). We model the significant physiological systems with conventional models expressed in ordinary differential equations (cardiopulmonary mechanics), coupling the anatomical and physiological modeling to produce an interactive simulation.

    The user can change parameters such as individual lung, ribcage, diaphragm, or mediastinum compliances or resistances during the simulation. As well, the user can introduce topological changes such as a chest wall breach (right or left), which produces a pneumothorax (which can be further qualified as simple, open, or tension). Our models consist of descriptions of the physical components and the laws that govern their interaction (such as volume balance), making them amenable to serve as a foundation for a wide variety of physiological and pathophysiological behaviors. Our work is unique, to our knowledge, because of our multi-degree-of-freedom chest wall. We model individual contributions of the ribcage, diaphragm, abdomen, two lungs, play among ribs, and the mediastinum. With this model, we can model a wide range of physiological and pathophysiological behavior, including pneumothoraces and paradoxical breathing.

    Click here for some sample images and descriptions.


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