Presented By: Biomedical Engineering
Biomedical Engineering Seminar Series
"Developing a multi-scale closed-loop model for hemorrhagic shock, REBOA and resuscitation: Failures, successes, and new paths forward," with Ellie Rahbar, Ph.D.
Abstract:
Hemorrhagic shock is the leading cause of preventable death after a traumatic injury, and accounts for 90% of military and 35% of civilian fatalities after trauma. Injuries to non-compressible intracavity regions, such as the chest and abdomen, are a major clinical challenge due to a lack of appropriate interventions, and represent 30-40% of early fatalities. To address this problem, endovascular hemorrhage control (EHC) devices and minimally invasive techniques such as Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) have been increasingly adopted. REBOA involves inflation of a balloon catheter in the aorta, which restricts blood flow distal to the occlusion and consequently minimizes bleeding. While REBOA is effective at restoring proximal perfusion, the reductions in distal blood flow can result in ischemia-reperfusion (I/R) injuries increasing the risk of subsequent renal failure. There is a pressing need to identify optimal occlusion size and duration of REBOA deployment to mitigate this risk. To date, large animal preclinical models have been predominantly used to answer these questions, but they are inherently expensive. Arguably, the lack of alternative tools to test EHC devices has hindered the growth and pace of innovation for hemorrhage control. Development of a robust in silico model for hemorrhage would significantly improve preclinical testing and optimization of EHC devices.
To address this gap, we proposed to develop and validate a novel multi-scale computational model that will allow us to simulate the in vivo physiologic response to hemorrhagic shock. Using a 3D-0D closed loop approach of the cardiovascular system (where total blood volume is conserved, as the sum of arterial and venous returns), we will be able to simulate the critical feedback loops and biologic response functions to render a physiologically relevant model. In this talk, I will share our ongoing work that utilizes large animal experiments and CFD modeling to characterize the acute and transient hemodynamic changes during hemorrhagic shock, aortic occlusion (via REBOA), and resuscitation. I will discuss some experimental challenges and highlight areas where both engineers and physicians can work together to improve our delivery of emergency and trauma care.
Bio:
Dr. Elaheh (Ellie) Rahbar received her B.S. in Materials Science and Engineering from Michigan State University in 2006 and Ph.D. in Biomedical Engineering, under the tutelage of Professor James E. Moore, Jr., at Texas A&M University in 2011. During her doctoral studies, Dr. Rahbar was a National Science Foundation Graduate Research Fellow (NSF-GRFP) and performed research in the area of lymphatic fluid mechanics. In fact she developed the first 3D CFD models for lymph flow and validated them with in situ animal data. She did her postdoctoral training at the Center for Translational Injury Research (CeTIR) at the University of Texas Medical School in Houston under the mentorship of Drs. John Holcomb and Charles Wade. During her postdoctoral training, she was an integral member of the PROMMTT and PROPPR multi-site clinical trials investigating optimal blood transfusion delivery to critically injured patients. In Jan. 2015, she became an Assistant Professor in Biomedical Engineering at Wake Forest University, part of the joint Virginia Tech – Wake Forest University School of Biomedical Engineering and Sciences graduate program where she established her independent lab in translational trauma research. Her research lab aims to engineer personalized solutions for the treatment and management of hemorrhagic shock, traumatic brain injury, and other critical injured conditions. She takes a holistic approach at studying the acute physiologic response to traumatic injuries and hemorrhage by integrating hemodynamic and biomarker changes over time. Over the past decade, Dr. Rahbar has had success in leading several research and training programs supported extramurally by NIH, NSF and DOD and has mentored over 70 trainees. In Jan. 2024, Dr. Rahbar returned to Texas A&M as a tenured Associate Professor in the Departments of Biomedical Engineering and Veterinary Physiology & Pharmacology at Texas A&M University with a vision to expand translational preclinical studies for both veterinary and human health.
Zoom:
https://umich.zoom.us/j/94337625486
Hemorrhagic shock is the leading cause of preventable death after a traumatic injury, and accounts for 90% of military and 35% of civilian fatalities after trauma. Injuries to non-compressible intracavity regions, such as the chest and abdomen, are a major clinical challenge due to a lack of appropriate interventions, and represent 30-40% of early fatalities. To address this problem, endovascular hemorrhage control (EHC) devices and minimally invasive techniques such as Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) have been increasingly adopted. REBOA involves inflation of a balloon catheter in the aorta, which restricts blood flow distal to the occlusion and consequently minimizes bleeding. While REBOA is effective at restoring proximal perfusion, the reductions in distal blood flow can result in ischemia-reperfusion (I/R) injuries increasing the risk of subsequent renal failure. There is a pressing need to identify optimal occlusion size and duration of REBOA deployment to mitigate this risk. To date, large animal preclinical models have been predominantly used to answer these questions, but they are inherently expensive. Arguably, the lack of alternative tools to test EHC devices has hindered the growth and pace of innovation for hemorrhage control. Development of a robust in silico model for hemorrhage would significantly improve preclinical testing and optimization of EHC devices.
To address this gap, we proposed to develop and validate a novel multi-scale computational model that will allow us to simulate the in vivo physiologic response to hemorrhagic shock. Using a 3D-0D closed loop approach of the cardiovascular system (where total blood volume is conserved, as the sum of arterial and venous returns), we will be able to simulate the critical feedback loops and biologic response functions to render a physiologically relevant model. In this talk, I will share our ongoing work that utilizes large animal experiments and CFD modeling to characterize the acute and transient hemodynamic changes during hemorrhagic shock, aortic occlusion (via REBOA), and resuscitation. I will discuss some experimental challenges and highlight areas where both engineers and physicians can work together to improve our delivery of emergency and trauma care.
Bio:
Dr. Elaheh (Ellie) Rahbar received her B.S. in Materials Science and Engineering from Michigan State University in 2006 and Ph.D. in Biomedical Engineering, under the tutelage of Professor James E. Moore, Jr., at Texas A&M University in 2011. During her doctoral studies, Dr. Rahbar was a National Science Foundation Graduate Research Fellow (NSF-GRFP) and performed research in the area of lymphatic fluid mechanics. In fact she developed the first 3D CFD models for lymph flow and validated them with in situ animal data. She did her postdoctoral training at the Center for Translational Injury Research (CeTIR) at the University of Texas Medical School in Houston under the mentorship of Drs. John Holcomb and Charles Wade. During her postdoctoral training, she was an integral member of the PROMMTT and PROPPR multi-site clinical trials investigating optimal blood transfusion delivery to critically injured patients. In Jan. 2015, she became an Assistant Professor in Biomedical Engineering at Wake Forest University, part of the joint Virginia Tech – Wake Forest University School of Biomedical Engineering and Sciences graduate program where she established her independent lab in translational trauma research. Her research lab aims to engineer personalized solutions for the treatment and management of hemorrhagic shock, traumatic brain injury, and other critical injured conditions. She takes a holistic approach at studying the acute physiologic response to traumatic injuries and hemorrhage by integrating hemodynamic and biomarker changes over time. Over the past decade, Dr. Rahbar has had success in leading several research and training programs supported extramurally by NIH, NSF and DOD and has mentored over 70 trainees. In Jan. 2024, Dr. Rahbar returned to Texas A&M as a tenured Associate Professor in the Departments of Biomedical Engineering and Veterinary Physiology & Pharmacology at Texas A&M University with a vision to expand translational preclinical studies for both veterinary and human health.
Zoom:
https://umich.zoom.us/j/94337625486
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