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Adult and Pediatric Porcine Model of Acute Volume Overload
In This Article
Summary
The protocol here shows how continuous administration of crystalloids into the central veins of a euvolemic pig/piglet allows for the appropriate investigation of the physiological effects of acute volume overload.
Abstract
This protocol describes an acute volume overload porcine model for adult Yorkshire pigs and piglets. Both swine ages undergo general anesthesia, endotracheal intubation, and mechanical ventilation. A central venous catheter and an arterial catheter are placed via surgical cutdown in the external jugular vein and carotid artery, respectively. A pulmonary artery catheter is placed through an introducer sheath of the central venous catheter. PlasmaLyte crystalloid solution is then administered at a rate of 100 mL/min in adult pigs and at 20 mL/kg boluses over 10 min in piglets. Hypervolemia is achieved either at 15% decrease in cardiac output or at 5 L in adult pigs and at 500 mL in piglets. Hemodynamic data, such as heart rate, respiratory rate, end-tidal carbon dioxide, fraction of oxygen-saturated hemoglobin, arterial blood pressure, central venous pressure, pulmonary artery pressure, pulmonary capillary wedge pressure, partial arterial oxygen pressure, lactate, pH, base excess, and pulmonary artery fraction of oxygen-saturated hemoglobin, are monitored during experimentation. Preliminary data observed with this model has demonstrated statistically significant changes and strong linear regressions between central hemodynamic parameters and acute volume overload in adult pigs. Only pulmonary capillary wedge pressure demonstrated both a linear regression and a statistical significance to acute volume overload in piglets. These models can aid scientists in the discovery of age-appropriate therapeutic and monitoring strategies to understand and prevent acute volume overload.
Introduction
Acute volume overload, a condition characterized by an abrupt and excessive increase in body fluid volume, is a critical medical concern that warrants comprehensive study1. It is often associated with aggressive and/or inappropriate fluid resuscitation, blood transfusion, and comorbidities such as heart failure and renal failure. It can lead to severe morbidity and an increased likelihood of mortality1,2,3. Despite its clinical significance, the pathophysiology of acute volume overload remains poorly understood3,
Protocol
The study protocol was approved by the Vanderbilt University Institutional Animal Care and Use Committee (protocol M1800176-00) and strictly adhered to the National Institute of Health Guidelines for the Care and Use of Laboratory Animals. Male and Female Yorkshire pigs and piglets weighing approximately 40-45 kg and 4-10 kg are used in this experiment. The present approach does not encompass a screening for preexisting medical conditions in the ordered swine. Acknowledging that this practice could potentially influence .......
Representative Results
The preliminary representative pilot data after linear regression analysis for the adult pig model demonstrated linearity to volume administration in the first eight pigs (Figure 2). While many other data points, and volume beyond 2.5 L, were measured during this experiment, these data represent the analysis to date. The two vital signs most used for volume assessment, HR (R2=0.15) and MAP (R2=0.79), both demonstrated a linear relationship during forced hypervolemia, bu.......
Discussion
There are two critical steps in this protocol. First, it is imperative that time is taken to obtain appropriate cannulation and ensure the positioning of hemodynamic/volume monitoring. In both adult and piglet models, surgical cutdown is necessary to cannulate the required vessel appropriately and introduce the required catheter. Percutaneous, ultrasound guided approaches have proven challenging and traumatic around the small caliber vessels seen in pigs and piglets. Two catheters that can present a challenge are the PAC.......
Acknowledgements
The authors would like to thank Dr. José A. Diaz, Jamie Adcock, and Mary Susan Fultz and the S.R. Light Laboratory at Vanderbilt University Medical Center for assistance and support. Another special thanks to John Poland and the rest of the Vanderbilt University Medical Center perfusionists and their students for their help with this study. This work was supported by a grant from the National Heart, Lung, and Blood Institute of the National Institutes of Health (BA; R01HL148244). The content is the sole responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
....Materials
| Name | Company | Catalog Number | Comments |
| 1% Isoflurane | Primal, Boston, MA, USA | 26675-46-7 | https://www.sigmaaldrich.com/US/en/product/aldrich/792632?gclid=Cj0KCQjw9fqnBhDSARIsAHl cQYS_W-q6tS2s6LQw2Qn7Roa3TGIpTLPf5 2351vrhgp44foEcRozPqtYaAtvfEAL w_wcB |
| Arterial Catheter | Merit Medical, South Jordan, UT, USA | MAK401 | MAK Mini Access Kit 4F |
| Arterial Catheter | Cook Medical, Bloomington, IN, USA | C-PMS-300-RA/G01908 | Radial Artery Catheter Set 3.0Fr./5cm |
| Blood Pressure Amp | AD Instruments, Colorado Springs, CO, USA | FE117 | https://www.adinstruments.com/products/bp-blood-pressure-amp |
| Central Venous Catheter Introducer | Arrow International Inc, Reading, PA, USA | AK-09800 | 8.5 Fr. x 4" (10 cm) Arrow-Flex |
| Central Venous Catheter-Introducer | Arrow International | CP-07611-P | Super Arrow-Flex Percutaneous Sheath Introducer Kit 6Fr./7.5cm |
| Disposable BP Transducers | AD Instruments, Colorado Springs, CO, USA | MLT0670 | https://www.adinstruments.com/products/disposable-bp-transducers |
| Kendall 930 FoamElectrodes | Covidien, Mansfield, MA, USA | 22935 | https://www.cardinalhealth.com/en/product-solutions/medical/patient-monitoring/electrocardiography/monitoring-ecg-electrodes/radiolucent-electrodes/kendall-930-series-radiolucent-foam-electrodes.html |
| LabChart 8 software | AD Instruments, Colorado Springs, CO, USA | N/A | https://www.adinstruments.com/products/labchart |
| Peripheral IV Catheter Angiocath 18-24 Gauge 1.16 inch | McKesson, Irving, TX, USA | 329830 | https://mms.mckesson.com/product/329830/Becton-Dickinson-381144 |
| PlamaLyte Crystilloid Solution | Baxter International, Deerfield, IL USA | 2B2544X | https://www.ciamedical.com/baxter-2b2544x-each-solution-plasma-lyte-a-inj-ph-7-4-1000ml |
| PowerLab | ADInstruments, Colorado Springs, CO, USA | N/A | https://www.adinstruments.com/products/powerlab/c?creative=532995768429&keyword= powerlab&matchtype=e&network= g&device=c&gclid=CjwKCAjwysipB hBXEiwApJOcu-ulfO0bfCc-j6B7PpO kOAGur8IZ4SWNkhNZ7mORGstO vKON6plWLxoCigsQAvD_BwE |
| Pulmonary Artery Catheter | Edwards Life Sciences, Irvine, CA, USA | TS105F5 | True Size Thermodilution Catheter 24cm Proximal Port- Swan Ganz |
| Pulmonary Artery Catheter (7F) | Edwards Life Sciences, Irvine, CA, USA | 131F7 | Swan Ganz 7F x 110cm |
| Telazol (Tiletamine HCl and Zolazepam HCl), Injectable Solution, 5 mL | Patterson Veterinary, Loveland, CO 80538 | 07-801-4969 | https://www.pattersonvet.com/ProductItem/078014969?omni=telazol |
| Terumo Sarns 8000 Roller Pump | Terumo Cardiovascular, Ann Arbor, MI, USA | 16402 | https://aamedicalstore.com/products/terumo-sarns%E2%84%A2-8000-roller-pump |
| Xylazine HCl 100 mg/mL, Injectable Solution, 50 mL | Patterson Veterinary, Loveland, CO 80538 | 07-894-5244 | https://www.pattersonvet.com/ProductItem/078945244 |
| Yorkshire Adult Pigs | Oak Hill Genetics, Ewing, IL, USA | N/A | Yorkshire/Landrace 81-100lbs |
| Yorkshire Piglets | Oak Hill Genetics | N/A | Female "piglet", specify age 5 weeks with a correlating healthy weight range (approximately 10-20lbs.) |
References
- Wise, E. S., et al. Hemodynamic parameters in the assessment of fluid status in a porcine hemorrhage and resuscitation model. Anesthesiology. 134 (4), 607-616 (2021).
- Rollins, K. E., Lobo, D. N.
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