{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T16:17:20Z","timestamp":1785428240280,"version":"3.56.0"},"reference-count":65,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T00:00:00Z","timestamp":1776470400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000182","name":"U.S. Army Medical Research and Development Command","doi-asserted-by":"publisher","award":["CO240020"],"award-info":[{"award-number":["CO240020"]}],"id":[{"id":"10.13039\/100000182","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000182","name":"U.S. Army Medical Research and Development Command","doi-asserted-by":"publisher","award":["W81XWH2020038"],"award-info":[{"award-number":["W81XWH2020038"]}],"id":[{"id":"10.13039\/100000182","id-type":"DOI","asserted-by":"publisher"}]},{"award":["CO240020"],"award-info":[{"award-number":["CO240020"]}],"id":[{"id":"https:\/\/ror.org\/03cd02q50","id-type":"ROR","asserted-by":"publisher"}]},{"award":["W81XWH2020038"],"award-info":[{"award-number":["W81XWH2020038"]}],"id":[{"id":"https:\/\/ror.org\/03cd02q50","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Hemorrhagic shock remains a leading cause of preventable death in trauma, yet traditional vital signs may fail to reflect early blood loss before physiological compensatory mechanisms are no longer able to maintain hemodynamic stability. The Compensatory Reserve Measurement (CRM) algorithm offers early detection capability using physiological waveforms but requires testing with emerging wearable sensor technologies for operational deployment. This study tested the Epicore Epidermal Patch for Imperceptible Care (EPIC) wearable healthcare device (WHD) for CRM-based hemodynamic monitoring during progressive central hypovolemia induced by lower-body negative pressure (LBNP) to simulate hemorrhage. Twenty participants underwent progressive LBNP while photoplethysmography (PPG) signals were recorded from EPIC sensors placed at the clavicle and triceps alongside a clinical-grade finger pulse oximeter for reference. Signal quality, heart-rate accuracy, and CRM predictions were evaluated across multiple filtering approaches. The triceps placement achieved signal quality comparable to the pulse oximeter reference when Chebyshev Type II filtering was applied, as well as high heart-rate accuracy. CRM derived from the EPIC sensor placed at the triceps tracked compensatory trends during progressive hypovolemia, but prediction magnitudes were inaccurate compared to calculated CRM values. In contrast, the clavicle placement consistently performed poorly across all measurements, regardless of the signal-processing approach. These findings support the feasibility of soft, flexible wearable sensors for continuous hemorrhage monitoring at the triceps location in operational environments where traditional finger-based pulse oximetry is impractical.<\/jats:p>","DOI":"10.3390\/s26082513","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T08:24:23Z","timestamp":1776673463000},"page":"2513","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Validation of a Wearable Photoplethysmography-Based Sensor for Compensatory Reserve Measurement Monitoring in Simulated Human Hemorrhage"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4325-409X","authenticated-orcid":false,"given":"Jose M.","family":"Gonzalez","sequence":"first","affiliation":[{"name":"United States Army Institute of Surgical Research, JBSA Fort Sam Houston, San Antonio, TX 78234, USA"},{"name":"Department of Biomedical Engineering and Chemical Engineering, University of Texas at San Antonio, San Antonio, TX 78249, USA"},{"name":"Graduate School of Biomedical Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Ortiz","sequence":"additional","affiliation":[{"name":"United States Army Institute of Surgical Research, JBSA Fort Sam Houston, San Antonio, TX 78234, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krysta-Lynn","family":"Amezcua","sequence":"additional","affiliation":[{"name":"United States Army Institute of Surgical Research, JBSA Fort Sam Houston, San Antonio, TX 78234, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Bedolla","sequence":"additional","affiliation":[{"name":"United States Army Institute of Surgical Research, JBSA Fort Sam Houston, San Antonio, TX 78234, 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Wake Forest School of Medicine, Winston-Salem, NC 27101, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5660-5082","authenticated-orcid":false,"given":"Weihua","family":"Li","sequence":"additional","affiliation":[{"name":"Epicore Biosystems, Inc., Cambridge, MA 02139, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8133-5026","authenticated-orcid":false,"given":"Alexander J.","family":"Aranyosi","sequence":"additional","affiliation":[{"name":"Epicore Biosystems, Inc., Cambridge, MA 02139, USA"},{"name":"Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL 60208, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3830-5980","authenticated-orcid":false,"given":"John A.","family":"Rogers","sequence":"additional","affiliation":[{"name":"Epicore Biosystems, Inc., Cambridge, MA 02139, USA"},{"name":"Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL 60208, USA"},{"name":"Department of Biomedical Engineering, Northwestern University, Evanston, IL 60208, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5380-2363","authenticated-orcid":false,"given":"Roozbeh","family":"Ghaffari","sequence":"additional","affiliation":[{"name":"Epicore Biosystems, Inc., Cambridge, MA 02139, USA"},{"name":"Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL 60208, USA"},{"name":"Department of Biomedical Engineering, Northwestern University, Evanston, IL 60208, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9246-0554","authenticated-orcid":false,"given":"Victor A.","family":"Convertino","sequence":"additional","affiliation":[{"name":"United States Army Institute of Surgical Research, JBSA Fort Sam Houston, San Antonio, TX 78234, 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