Updated abdominal compartment list for internal hemorrhage documentation.
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|A hemorrhage is a substantial blood loss that may lead to inadequate supply of oxygen to tissues and vital organs. Reduced blood volume leads to reduced cardiac output, reduced mean arterial pressure, and an increase in heart rate due to baroreceptor response. Hemorrhage is initiated in the engine by specifying the location (compartment) and bleed rate. Multiple hemorrhages may exist at any given time. The user can specify and cardiovascular compartment to apply a hemorrhage. After the hemorrhage has been specified, the total loss rate is the sum of each individual bleed rate to that compartment. This value is set as a negative flow source. This results in a decrease in total blood volume that is linearly proportional to the total loss rate. This decrease in blood volume leads to a drop in arterial pressures and cardiac output. The baroreceptor reflex initiates an increase in heart rate to compensate for the reduced mean arterial pressure.|
|An internal hemorrhage can also be specified for abdominal cardiovascular compartments, including the aorta, stomach, splanchnic, right and left kidneys, and liver. The internal hemorrhage allows blood to flow into the abdominal cavity, increasing the pressure in the cavity. This pressure is applied to the aorta, increasing the localized blood pressure as a result of internal blood accumulation.|
|An internal hemorrhage can also be specified for abdominal cardiovascular compartments, including the aorta, vena cava, stomach, splanchnic, spleen, right and left kidneys, large and small intestines, and liver. The internal hemorrhage allows blood to flow into the abdominal cavity, increasing the pressure in the cavity. This pressure is applied to the aorta, increasing the localized blood pressure as a result of internal blood accumulation.|
|Additionally, as there is a decrease in total blood volume, there is an associated decrease in the substances found in the blood. Like blood volume, the decrease in the substance will be linearly proportional to the bleed rate. For more specific information regarding these substances and their loss due to bleeding, see @ref BloodChemistryMethodology and @ref SubstanceTransportMethodology. Figure 8 shows the blood volume and hemoglobin content before, during, and after a massive hemorrhage event with no intervention other than the cessation of hemorrhage. Figure 9 shows a hemorrhage event with subsequent saline administration. Note that the hemoglobin content remains diminished as the blood volume recovers with IV saline. By comparison, [Figure 11](@ref cardiovascular-blood-administration) shows a blood-product intervention following a hemorrhage event. In that figure, the hemoglobin increases with the blood infusion.|