title: A novel approach to modeling acute normovolemic hemodilution.
abstract: Acute normovolemic hemodilution (ANH) was introduced as a blood conservation technique to reduce patient exposure to allogenic blood transfusion during surgery. Despite years of research and experience, the best practice procedure, efficacy and safety of ANH remain in question. In this work, a numerical model is developed for the ANH procedure based upon a multi-compartmental, fluid model of the body. The model also analyzes the most commonly used acellular fluids for ANH or for fluid therapy following hemorrhage. The model allows user input of critical ANH parameters, providing the ability to simulate the patient׳s response in real time to many clinical scenarios, using various types of resuscitation fluids. First, the patient׳s response to a representative, clinical ANH protocol and surgery was simulated. Then, the effect of several variables was investigated including: type/amount of resuscitation fluid, number of blood units collected during ANH, and amount of surgical blood loss. Our simulations highlighted the importance of osmotic molecules within the blood in preventing excessive fluid retention and initiating fluid clearance after surgery. The developed model can be utilized as a tool to simulate and optimize a variety of proposed protocol related to the ANH procedure and surgery. It can also be utilized as an educational or training tool to become familiar with the ANH procedure.
authors.affiliation: Department of Biomedical Engineering, Florida Institute of Technology, 150 West University Blvd, Melbourne, FL 32901, United States. Electronic address: bpliskow2013@my.fit.edu.
authors.forename: Bradley
authors.initials: B
authors.lastname: Pliskow
authors.affiliation: Department of Biomedical Engineering, Rutgers University, Piscataway, NJ 08854, United States; College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China. Electronic address: johnkjli@rci.rutgers.edu.
authors.forename: John K-J
authors.initials: JK
authors.lastname: Li
authors.affiliation: Department of Biomedical Engineering, Rutgers University, 1733 Port Place Apt. 401, Reston, VA 20194, United States. Electronic address: oharada@aol.com.
authors.forename: Dorene
authors.initials: D
authors.lastname: O'Hara
authors.affiliation: Department of Biomedical Engineering, Florida Institute of Technology, 150 West University Blvd, Melbourne, FL 32901, United States. Electronic address: mkaya@fit.edu.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kaya
mesh_terms: D016063:Blood Loss, Surgical / Q000517:prevention & control*; D005440:Fluid Therapy / Q000379:methods*; D006438:Hemodilution / Q000379:methods*; D006801:Humans; D008955:Models, Cardiovascular
keywords: Acute normovolemic hemodilution; Colloids; Compartmental model; Computer model; Crystalloids; Fluid resuscitation; Fluid-exchange model; Hematocrit; Surgical blood loss