Project Summary: Hemorrhagic shock is the leading cause of early mortality in people aged 1-44 years old, following a traumatic injury. A significant proportion of these early fatalities are associated with non-compressible truncal hemorrhage (NCTH). Endovascular approaches such as Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) and Partial Resuscitative Endovascular Balloon Occlusion of the Aorta (pREBOA) have evolved as an effective way to manage NCTH. However, the optimal implementation (i.e., occlusion size, timing, and duration of device deployment) remains largely unknown since hemostatic control must be maintained. Additionally, little is known about how the use of an endovascular hemorrhage control device alters other aspects of resuscitation and critical care management, such as total pressor and fluid requirements. To address this knowledge gap, this diversity supplement project seeks to: (1) examine the impact of partial and complete aortic occlusion on the effectiveness of resuscitation as measured by the total pressor and crystalloid fluid requirements and (2) exploit machine learning approaches to identify early hemodynamic patterns that are associated with hypoperfusion and inadequate resuscitation. Dr. Gomez has proposed a detailed mentoring and training plan that will provide a strong foundation in research development and grantsmanship, translational science, and quantitative analysis/modelling through formal didactic training, workshops, conferences, research seminars beyond the experiences gathered through the conduct of proposed research aims in this supplement and the parent grant. The environment at Wake Forest University School of Medicine is excellent for this research with access to resources through the PI’s lab, the Center for Translational Science Institute and Center for Artificial Intelligence that will provide supplementary professional training in translational research and machine learning. The long-term goal of this project is to identify key hemodynamic and temporal patterns that are associated with inadequate resuscitation and hypoperfusion such that improved resuscitation and vasopressor management can be delivered to critically injured patients. Understanding how endovascular devices such as REBOA and pREBOA alter vascular response and resuscitation across different hemorrhage levels will allow us to better understand how to implement these devices into patient care, including the refinement of automated critical care platforms. This proposed project will certainly aid in propelling Dr. Gomez’s carer in academic medicine and translational science.