Name: brachial artery catheterization in swine
Uploaded: 2019-03-30T13:00:00
Description: Watch this Scientific Journal Video about Brachial Artery Catheterization in Swine at JoVE.com

This work was supported by the Canadian Institutes of Health Research and Canada Foundation for Innovation grant to V. K. Mushahwar. A. Toossi was supported by a Vanier Canada Graduate Scholarship, Alberta Innovates - Health Solutions Graduate Studentship and a Queen Elizabeth II Graduate Scholarship. V.K. Mushahwar is a Canada Research Chair in Functional Restoration. We would like to acknowledge Mr. J. Stack of Moss Street Productions for his help with the audio production and staff of the Surgical Medical Research Institute for their assistance with the procedures.

All procedures on experimental animals described in both the video and manuscript were approved by the Institutional Animal Care and Use Committee of the University of Alberta
1. Surgical anesthesia and surgical preparation of the pigs.
<ol>
	<li>Premedicate 50 kg Landrace-Yorkshire commercial pigs intramuscularly with the anesthetic drug cocktail containing ketamine hydrochloride (22 mg/kg,), xylazine hydrochloride (2.2 mg/kg) and glycopyrrolate hydrochloride (10 &#181;g/kg).</li>
	<li>Set ...

<ol>
	<li>Uwiera, R. R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Plasmid+DNA+induces+increased+lymphocyte+trafficking:+a+specific+role+for+CpG+motifs.">Plasmid DNA induces increased lymphocyte trafficking: a specific role for CpG motifs.</a> Cellular Immunology. 214 (2), 155-164 (2001).</li><li>Uwiera, R. R., Kastelic, J. P., Inglis, G. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Catheterization+of+intestinal+loops+in+ruminants.">Catheterization of intestinal loops in ruminants.</a> Journal of Visualized Experiments. (28), (2009).</li><li>Uwiera, R. R., Mangat, R., Kelly, S., Uwiera, T. C., Proctor, S. 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M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Equine+anaesthesia-associated+mortality:+where+are+we+now?.">Equine anaesthesia-associated mortality: where are we now?.</a> Veterinay Anaesthesia Analgesia. 43 (3), 242-255 (2016).</li><li>McGrotty, Y., Brown, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Blood+gases,+electrolytes+and+interpretation+1.+Blood+gases.">Blood gases, electrolytes and interpretation 1. Blood gases.</a> In Practice. 35 (2), 59-65 (2013).</li><li>Taylor, P. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Techniques+and+clinical+application+of+arterial+blood+pressure+measurement+in+the+horse.">Techniques and clinical application of arterial blood pressure measurement in the horse.</a> Equine Veterinary Journal. 13, 271-275 (1981).</li><li>Trim, C. M., Hofmeister, E. H., Quandt, J. E., Shepard, M. 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M., Beckett, S. D., Branch, C. E., McDaniel, G. R., Patterson, R. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cardiovascular+Responses+in+Turkeys+as+Affected+by+Diurnal+Variation+and+Stressor.">Cardiovascular Responses in Turkeys as Affected by Diurnal Variation and Stressor.</a> Poultry Science. (60), 462-468 (1981).</li><li>Bass, L. M., Yu, D. Y., Cullen, L. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparison+of+femoral+and+auricular+arterial+blood+pressure+monitoring+in+pigs.">Comparison of femoral and auricular arterial blood pressure monitoring in pigs.</a> Veterinay Anaesthesia Analgesia. 36 (5), 457-463 (2009).</li><li>Karnabatidis, D., Katsanos, K., Diamantopoulous, A., Kagadis, G. C., Siablis, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transauricular+arterial+or+venous+access+for+cardiovascular+experimental+protocols+in+animals.">Transauricular arterial or venous access for cardiovascular experimental protocols in animals.</a> Journal of Vascular and Interventional Radiology. 17 (11 Pt 1), 1803-1811 (2006).</li><li>Namba, K., Kawamura, Y., Higaki, A., Nemoto, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Percutaneous+medial+saphenous+artery+approach+for+Swine+central+artery+access.">Percutaneous medial saphenous artery approach for Swine central artery access.</a> Journal of Investigative Surgery. 26 (6), 360-363 (2013).</li><li>Hong, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Feasibility+of+Selective+Catheter-Directed+Coronary+Computed+Tomography+Angiography+Using+Ultralow-Dose+Intracoronary+Contrast+Injection+in+a+Swine+Model.">Feasibility of Selective Catheter-Directed Coronary Computed Tomography Angiography Using Ultralow-Dose Intracoronary Contrast Injection in a Swine Model.</a> Investigative Radiology. (50), 449-455 (2015).</li><li>Kumar, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Aortic+root+catheter-directed+coronary+CT+angiography+in+swine:+coronary+enhancement+with+minimum+volume+of+iodinated+contrast+material.">Aortic root catheter-directed coronary CT angiography in swine: coronary enhancement with minimum volume of iodinated contrast material.</a> American Journal of Roentgenology. (188), W415-W422 (2007).</li><li>Park, J. H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Safety+and+Efficacy+of+an+Aortic+Arch+Stent+Graft+with+Window-Shaped+Fenestration+for+Supra-Aortic+Arch+Vessels:+an+Experimental+Study+in+Swine.">Safety and Efficacy of an Aortic Arch Stent Graft with Window-Shaped Fenestration for Supra-Aortic Arch Vessels: an Experimental Study in Swine.</a> Korean Circulation Journal. 47 (2), 215-221 (2017).</li><li>Carniato, S., Mehra, M., King, R. M., Wakhloo, A. K., Gounis, M. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Porcine+brachial+artery+tortuosity+for+in+vivo+evaluation+of+neuroendovascular+devices.">Porcine brachial artery tortuosity for in vivo evaluation of neuroendovascular devices.</a> American Journal of Neuroradiology. 34 (4), E36-E38 (2013).</li><li>Hannon, J. P., Bossone, C. A., Wade, C. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Normal+Physiological+Values+for+Consious+pigs+used+in+Biomedical+Research.">Normal Physiological Values for Consious pigs used in Biomedical Research.</a> Laboratory Animal Science. 40, 293-298 (1990).</li><li>Nijland, M. J., Shankar, U., Iyer, V., Ross, M. G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Assessment+of+fetal+scalp+oxygen+saturation+determination+in+the+sheep+by+transmission+pulse+oximetry.">Assessment of fetal scalp oxygen saturation determination in the sheep by transmission pulse oximetry.</a> American Journal of Obstetrics and Gynecology. 183 (6), 1549-1553 (2000).</li><li>Yawno, T., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Human+Amnion+Epithelial+Cells+Protect+Against+White+Matter+Brain+Injury+After+Repeated+Endotoxin+Exposure+in+the+Preterm+Ovine+Fetus.">Human Amnion Epithelial Cells Protect Against White Matter Brain Injury After Repeated Endotoxin Exposure in the Preterm Ovine Fetus.</a> Cell Transplantation. 26 (4), 541-553 (2017).</li><li>Amaya, K. E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Accelerated+acidosis+in+response+to+variable+fetal+heart+rate+decelerations+in+chronically+hypoxic+ovine+fetuses.">Accelerated acidosis in response to variable fetal heart rate decelerations in chronically hypoxic ovine fetuses.</a> American Journal of Obstetrics and Gynecology. 214 (2), e270-e271 (2016).</li><li>Malavasi, L. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Swine. Anesthesia and Analgesia for Domestic Species. , (2015).</li><li>Moon, P. F., Smith, L. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=General+Anesthetic+Techniques+in+Swine.">General Anesthetic Techniques in Swine.</a> Veterinary Clinics of North America: Food Animal Practice. 12 (3), 663-691 (1996).</li><li>Caramoni, P. R. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Postangioplasty+restenosis:+a+practical+model+in+the+porcine+carotid+artery.">Postangioplasty restenosis: a practical model in the porcine carotid artery.</a> Brazilian Journal of Medical and Biological Research. (30), 1087-1091 (1997).</li><li>Sisson, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> The Anatomy of the Domestic Animals. , 636-638 (1930).</li><li>Lundeed, A. B., Manohar, M., Parks, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Systemic+distribution+of+blood+flow+in+swine+while+awake+and+during+1.0+and+1.5+MAC+isoflurane+anesthesia+with+or+without+50%+nitrous+oxide.">Systemic distribution of blood flow in swine while awake and during 1.0 and 1.5 MAC isoflurane anesthesia with or without 50% nitrous oxide.</a> Anesthesia and Analgesia. 31, 499-512 (1983).</li><li>Sisson, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> The Anatomy of the Domestic Animals. , 302-304 (1930).</li><li>Adin, C. A., Gregory, C. R., Adin, D. B., Cowgill, L. D., Kyles, A. 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W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparison+of+indirect+and+direct+blood+pressure+monitoring+in+normotensive+swine.">Comparison of indirect and direct blood pressure monitoring in normotensive swine.</a> Research in Veterinary Science. 95 (2), 699-702 (2013).</li><li>Wenzel, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Survey+of+Effects+of+Anesthesia+Protocols+on+Hemodynamic+Variables+in+Porcine+Cardiopulmonary+Resuscitation+Laboratory+Models+Before+Induction+of+Cardiac+Arrest.">Survey of Effects of Anesthesia Protocols on Hemodynamic Variables in Porcine Cardiopulmonary Resuscitation Laboratory Models Before Induction of Cardiac Arrest.</a> Comparative Medicine. 50 (6), 644-648 (2000).</li><li>Duval, J. D., Pang, J. M., Boysen, S. R., Caulkett, N. 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Arterial catheterization to measure arterial blood pressures and collect blood samples for arterial blood gas measurements has been established in a wide range of animal species5,6,7,8,9,10,11,12,13,<sup class="...

Surgical intervention is used in experimental research to develop animal models that enhance scientific development. The scientific literature is filled with examples of novel surgical animal models1,2,3. Surgical procedures are a complex process involving not only the manipulation of anatomical structures but also complicated physiological interactions with various drugs required for anesthesia and analgesia. This interplay can induce major changes in physiological processes within the animal and as such requires vigilant monitoring of the animal4. Clinically successful surgical outcomes have been associated with measurements of arterial blood gases and arterial blood pressures5. These clinical parameters require the ability to measure arterial blood pressure and collect arterial blood effectively, which in turn requires the successful catheterization of an artery6,7.
Arterial catheterization to collect arterial blood and measure pressure has been used in various animal species5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21 and in animals at different ages of development19,20,21 and has been directed at both recovery (clinical and diagnostic) procedures4,5,6,7,8 and non-recovery (experimental) procedures14,15,16,17,18. Moreover, the ease of arterial access and the location of the artery in the context of the surgical procedure are also important considerations when choosing an artery for arterial blood measurements. For example, the median caudal artery in dogs and the facial artery in horses, as well as the pedal artery in both dogs and horses, are used for diagnostic measurement and monitoring during recovery procedures6,7,8. In contrast, the carotid and femoral arteries are often catheterized in swine for either non-recovery or long-term catheter implantation experiments14,15,18.
In swine, arterial catheterization to measure either arterial blood pressure or collect arterial blood has routinely employed either the carotid, femoral, medial saphenous, or auricular arteries22,23. For specialized non-routine procedures, other more unusual arteries have been used, including the subclavian and iliac arteries, to measure the brachial artery anatomical tortuosity17 and image the aorta16, respectively. Regardless of which artery is chosen for catheterization, each artery has inherent advantages and disadvantages for its use. For instance, the auricular artery is anatomically easy to access, but its use may be limited to its close proximity to the marginal ear veins11,12. In comparison, the carotid artery is relatively large and robust24, but it lies deep within the jugular furrow and requires substantive tissue dissection25. As such, identifying another artery that could be catheterized to measure arterial pressure and collect arterial blood is warranted. This video and manuscript describe in detail the catheterization of the distal brachial artery in swine, a technique that could be applied to non-recovery procedures. Notably, the pig brachial artery catheterization was used to measure arterial blood pressures and arterial blood gas parameters during a lumbar spine surgery with hind limb measurements (the data from this part of the surgery is not presented).

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	<tbody>
		<tr height="20">
			<td height="20" style="height:20px;width:252px;">0.9% NaCl (Saline) Solution</td>
			<td style="width:122px;">EMRN</td>
			<td style="width:123px;">JB1322P</td>
			<td style="width:250px;">1 x1 liter bag</td>
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			<td height="20" style="height:20px;width:252px;">10% Lidocaine spray</td>
			<td style="width:122px;">AstraZeneca</td>
			<td style="width:123px;"></td>
			<td style="width:250px;">DIN:02039508 / 1 x&#160; 50 ml&#160; bottle</td>
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			<td height="20" style="height:20px;width:252px;">10% Povidone-Iodine scrub</td>
			<td style="width:122px;">Purdue Pharma</td>
			<td style="width:123px;">521232</td>
			<td style="width:250px;">1 x 500 ml bottle&#160;</td>
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			<td height="40" style="height:40px;width:252px;">20 ga 1-inch angiocatheter</td>
			<td style="width:122px;">Becton Dickinson</td>
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			<td style="width:250px;">1 x angiocatheter</td>
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			<td height="20" style="height:20px;width:252px;">2-0 polyglactin suture (Vicryl)</td>
			<td style="width:122px;">Ethicon</td>
			<td style="width:123px;">J339H</td>
			<td style="width:250px;">2-0 vicryl / 1 packet of suture</td>
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			<td height="40" style="height:40px;width:252px;">2-0 polypropylene suture (Prolene)&#160;</td>
			<td style="width:122px;">Ethicon</td>
			<td style="width:123px;">8833H</td>
			<td style="width:250px;">2-0 prolene / 1 packet of suture</td>
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		<tr height="40">
			<td height="40" style="height:40px;width:252px;">22 ga 1-inch angiocatheter</td>
			<td style="width:122px;">Becton Dickinson</td>
			<td style="width:123px;">381423</td>
			<td style="width:250px;">1 x angiocatheter</td>
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		<tr height="20">
			<td height="20" style="height:20px;width:252px;">9 ID mm endotracheal tube</td>
			<td style="width:122px;">Jorvet</td>
			<td style="width:123px;">J0835P</td>
			<td style="width:250px;">1 x endotracheal tube</td>
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			<td height="40" style="height:40px;width:252px;">Arterial blood pressure IV line</td>
			<td style="width:122px;">Argon Medical Devices</td>
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			<td style="width:250px;">1 x arterial blood pressure IV line</td>
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			<td style="width:250px;">4-8 x disposable drapes&#160;</td>
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			<td height="20" style="height:20px;width:252px;">Glycopyrrolate hydrochloride&#160;</td>
			<td style="width:122px;">Sandoz</td>
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			<td style="width:250px;">DIN:02039508 / 1 x 20ml vial</td>
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			<td height="40" style="height:40px;width:252px;">Isoflurane</td>
			<td style="width:122px;">Abbott Animal&#160; Health</td>
			<td style="width:123px;">05260-5</td>
			<td style="width:250px;">1 x 250ml bottle</td>
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			<td height="20" style="height:20px;width:252px;">Kelly forceps-curved (14cm)</td>
			<td style="width:122px;">Stevens</td>
			<td style="width:123px;">162-7-38</td>
			<td style="width:250px;">8-10&#160; instruments</td>
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			<td height="20" style="height:20px;width:252px;">Ketamine hydrochloride</td>
			<td style="width:122px;">Vetoquinol</td>
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			<td style="width:250px;">DIN:02374994 / 1 x 10ml vial</td>
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			<td height="21" style="height:21px;width:252px;">Lactated Ringer&#39;s Solution</td>
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			<td style="width:123px;">0409-7953-09</td>
			<td style="width:250px;">4 x1 liter bag</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:252px;">Metzenbaum scissors</td>
			<td style="width:122px;">Fine Science</td>
			<td style="width:123px;">14518-18</td>
			<td style="width:250px;"></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:252px;">Miller laryngoscope blade</td>
			<td style="width:122px;">Welch Allyn</td>
			<td style="width:123px;">68044</td>
			<td style="width:250px;">182 mm length&#160; / 1 instrument</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:252px;">Nasal temperature probe</td>
			<td style="width:122px;">Surgivet</td>
			<td style="width:123px;">V3417</td>
			<td style="width:250px;">1 probe</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:252px;">Needle Drivers</td>
			<td style="width:122px;">Stevens</td>
			<td style="width:123px;">162-V98-42</td>
			<td style="width:250px;">2 instruments</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:252px;">Q tip applicators</td>
			<td style="width:122px;">Fisher Scientific</td>
			<td style="width:123px;">22-037-960</td>
			<td style="width:250px;">20-40&#160; app</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:252px;">Remifentanil hydrochloride</td>
			<td style="width:122px;">TEVA</td>
			<td style="width:123px;"></td>
			<td style="width:250px;">DIN:0234432 / 1 mg vial</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:252px;">Surgivet advisor: Vital signs monitor</td>
			<td style="width:122px;">Surgivet</td>
			<td style="width:123px;">V9203</td>
			<td style="width:250px;">1 monitor</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:252px;">Weitlaner retractor</td>
			<td style="width:122px;">Stevens</td>
			<td style="width:123px;">162-11-602</td>
			<td style="width:250px;">&#160;2 retractors</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:252px;">Xylazine hydrochloride</td>
			<td style="width:122px;">Bayer</td>
			<td style="width:123px;"></td>
			<td style="width:250px;">DIN:02169606 1 x 50ml bottle</td>
		</tr>
	</tbody>
</table>

brachial artery catheterization in swine

The video describes in detail the catheterization of the distal brachial artery in swine. This technique enables researchers to measure arterial blood pressure continuously and collect arterial blood samples to assess arterial blood gas measurements. Arterial blood pressures and arterial blood gases are important physiological parameters to monitor during experimental procedures. In swine, four common methods of arterial catheterization have been described, including catheterization of the carotid, femoral, auricular, and medial saphenous arteries. Each of these techniques have advantages, such as ease of access for the auricular artery, and disadvantages that include deep tissue dissection for carotid artery catheterization. The described alternative method of arterial catheterization in swine, the catheterization of the distal aspect of the brachial artery, is a rapid procedure that requires relatively minimal tissue dissection and provides information that is in line with data collected from other arterial catheterization sites. The procedure uses a medial approach along an oblique plane of the lower brachium, positioned between the olecranon and the flexor aspect of the elbow joint, and this approach allows researchers the major advantage of unimpeded freedom for procedures that involve the caudoventral, caudodorsal back, or hind limbs of the pig. Due to the location of the upper forelimb of the catheterized vessel and potential challenges of effective homeostasis following catheter removal from the artery, this technique may be limited to non-recovery procedures.

Brachial artery catheterization allows for continuous monitoring of arterial blood pressure and intermittent sampling of arterial blood during extended surgical procedures in swine. Measured parameters were collected from seven 50 kg Landrace-Yorkshire commercial pigs as described. The total time required to catheterize the brachial artery was 35.2 &#177; 4.4 min from the initial artery landmarking to final surgical incision closure (Figure 1). The arterial p...

Watch this Scientific Journal Video about Brachial Artery Catheterization in Swine at JoVE.com

Brachial Artery Catheterization in Swine

The video describes in detail the catheterization of the distal brachial artery in swine. This procedure accurately measures arterial blood pressure and is a simple and fast method to collect samples for arterial blood gas measurements.

The video describes in detail the catheterization of the distal brachial artery in swine. This technique enables researchers to measure arterial blood ...

Measuring arterial blood pressure, and collecting arterial blood gas for analyzing arterial blood gases, are important considerations when monitoring animals undergoing surgery. This video describes in detail the catheterization of the brachial artery, a relatively fast and simple procedure, that is particularly useful for procedures that involve the caudal ventral and caudal dorsal back and hind limbs of pigs. This video is a compilation of the brachial artery catheterization of three pigs, and is also part of a non-recovery surgical procedure.The anesthetic protocol includes, one, the intramuscular administration of a premedication cocktail that contains, ketamine hydrochloride, xylazine hydrochloride, and glycopyrrolate hydrochloride. Two, inhalational anesthesia with isoflurane gas, and three, intravenous analgesia, with continuous remifentanil hydrochloride infusion. The the distal brachial artery is found by digital palpation.The surgical site is marked. The artery lies between the olecranon, and the flexor aspect of the elbow joint. The artery travels in a proximal direction towards the scapula, and traverses the humerus.A 10%povidone iodine surgical scrub solution is applied to the site of brachial artery catheterization. To access the artery, the skin is incised with a scalpel. The skin incision is approximately six centimeters in length.Use gentle tissue dissection with blunt instruments, and swabs, to identify the artery. A retractor is used to separate the tissues, allowing better access to the underlying structures. Continue gentle dissection.Tissues are moistened with warm saline. The brachial artery, brachial vein, and median nerve, are identified by uppercase letters, A, V, and N, respectively. Create a tunnel underneath the artery with blunt instruments.Three two zero polyglactin sutures are passed underneath the brachial artery. The artery displays strong arterial blood pressure pulsations. The sutures are intentionally placed loosely around the artery.A distal suture is used to occlude the vessel, and later secures the catheter into the vessel. The proximal sutures are used to secure the catheter within the vessel. Insert the catheter into the artery, and advance the catheter into the vessel to the catheter hub.The middle suture secures the catheter within the artery. Remove the stylet, and quickly cap the catheter to minimize bleeding. Flush the area with warm saline.Secure the distal suture around the catheter hub. Attach the intravenous extension line to the catheter. Flush with warm saline, and clean the area.Flush the catheter with saline to ensure catheter patency, and good arterial blood flow. Two additional sutures are secured around the catheter hub, to enhance catheter stability. The muscle layer is closed with two zero polyglactin suture, using a simple continuous suture pattern.The skin is closed with two zero polypropylene suture, using a simple interrupted suture pattern. For optimal arterial blood pressure measurements, a catheterized foramen is extended at a 40-degree angle from the midline of the pig's vertebral column. The monitor shows hemodynamic and respiratory parameters, and body temperature.The arterial blood pressure values, and arterial pressure waves, are shown in purple. Figure one represents the time required to catheterize the brachial artery in seven pigs. The average time to catheterize the pigs was 35.2 minutes.The solid line represents the mean, and the shaded area represents the standard error of the mean. Figure two represents averaged arterial blood pressure measurements during 120 minutes of surgery. Blood pressure measurements include arterial systolic pressure, arterial diastolic pressure, and mean arterial pressure.Table one represents average brachial artery blood measurements. Time zero minutes shows the arterial blood measurements collected prior to surgery. Time 120 minutes shows the brachial artery measurements following 120 minutes of surgery.In conclusion, the catheterization of brachial arteries in pigs, is an excellent alternative method to measure arterial blood pressure, and collect arterial blood, for blood gas sampling. Although brachial artery catheterization requires modest amounts of tissue dissection, it is a relatively rapid procedure that can reliably produce accurate arterial blood measurements.

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JoVE Journal

Medicine

Basic Surgical Techniques in the G&ouml;ttingen Minipig: Intubation, Bladder Catheterization, Femoral Vessel Catheterization, and Transcardial Perfusion

The emergence of the G&ouml;ttingen minipig in research of topics such as neuroscience, toxicology, diabetes, obesity, and experimental surgery reflects the close resemblance of these animals to human anatomy and physiology 1-6.The size of the G&ouml;ttingen minipig permits the use of surgical equipment and advanced imaging modalities similar to those used in humans 6-8. The aim of this instructional video is to increase the awareness on the value of minipigs in biomedical research, by demonstrating how to perform tracheal intubation, transurethral bladder catheterization, femoral artery and vein catheterization, as well as transcardial perfusion. 
Endotracheal Intubation should be performed whenever a minipig undergoes general anesthesia, because it maintains a patent airway, permits assisted ventilation and protects the airways from aspirates. Transurethral bladder catheterization can provide useful information about about hydration state as well as renal and cardiovascular function during long surgical procedures. Furthermore, urinary catheterization can prevent contamination of delicate medico-technical equipment and painful bladder extension which may harm the animal and unnecessarily influence the experiment due to increased vagal tone and altered physiological parameters. Arterial and venous catheterization is useful for obtaining repeated blood samples and monitoring various physiological parameters. Catheterization of femoral vessels is preferable to catheterization of the neck vessels for ease of access, when performing experiments involving frame-based stereotaxic neurosurgery and brain imaging. When performing vessel catheterization in survival studies, strict aseptic technique must be employed to avoid infections6. Transcardial perfusion is the most effective fixation method, and yields preeminent results when preparing minipig organs for histology and histochemistry2,9. For more information about anesthesia, surgery and experimental techniques in swine in general we refer to Swindle 2007. Supplementary information about premedication and induction of anesthesia, assisted ventilation, analgesia, pre- and postoperative care of G&ouml;ttingen minipigs are available via the internet at <a href="http://www.minipigs.com">http://www.minipigs.com</a>10. For extensive information about porcine anatomy we refer to Nickel et al. Vol. 1-511.

Basic Surgical Techniques in the G&amp;#246;ttingen Minipig: Intubation, Bladder Catheterization, Femoral Vessel Catheterization, and Transcardial Perfusion

The use of domestic and miniature pigs in science has increased significantly in recent years. By demonstrating how to perform intubation, transurethral bladder catheterization, femoral artery and vein catheterization, as well as transcardial perfusion, we aim to further increase the value of G&ouml;ttingen minipigs in biomedical research.

The emergence of the G&ouml;ttingen minipig in research of topics such as neuroscience, toxicology, diabetes, obesity, and experimental surgery reflects ...

A Swine Model of Neonatal Asphyxia

Annually more than 1 million neonates die worldwide as related to asphyxia. Asphyxiated neonates commonly have multi-organ failure including hypotension, perfusion deficit, hypoxic-ischemic encephalopathy, pulmonary hypertension, vasculopathic enterocolitis, renal failure and thrombo-embolic complications. Animal models are developed to help us understand the patho-physiology and pharmacology of neonatal asphyxia. In comparison to rodents and newborn lambs, the newborn piglet has been proven to be a valuable model. The newborn piglet has several advantages including similar development as that of 36-38 weeks human fetus with comparable body systems, large body size (&tilde;1.5-2 kg at birth) that allows the instrumentation and monitoring of the animal and controls the confounding variables of hypoxia and hemodynamic derangements.
We here describe an experimental protocol to simulate neonatal asphyxia and allow us to examine the systemic and regional hemodynamic changes during the asphyxiating and reoxygenation process as well as the respective effects of interventions. Further, the model has the advantage of studying multi-organ failure or dysfunction simultaneously and the interaction with various body systems. The experimental model is a non-survival procedure that involves the surgical instrumentation of newborn piglets (1-3 day-old and 1.5-2.5 kg weight, mixed breed) to allow the establishment of mechanical ventilation, vascular (arterial and central venous) access and the placement of catheters and flow probes (Transonic Inc.) for the continuously monitoring of intra-vascular pressure and blood flow across different arteries including main pulmonary, common carotid, superior mesenteric and left renal arteries. Using these surgically instrumented piglets, after stabilization for 30-60 minutes as defined by Z&lt;10% variation in hemodynamic parameters and normal blood gases, we commence an experimental protocol of severe hypoxemia which is induced via normocapnic alveolar hypoxia. The piglet is ventilated with 10-15% oxygen by increasing the inhaled concentration of nitrogen gas for 2h, aiming for arterial oxygen saturations of 30-40%. This degree of hypoxemia will produce clinical asphyxia with severe metabolic acidosis, systemic hypotension and cardiogenic shock with hypoperfusion to vital organs. The hypoxia is followed by reoxygenation with 100% oxygen for 0.5h and then 21% oxygen for 3.5h. Pharmacologic interventions can be introduced in due course and their effects investigated in a blinded, block-randomized fashion.

Large animal models have good translational values in the examination of physiology and pharmacology of neonatal asphyxia. Using newborn piglets, we develop an experimental protocol to simulate neonatal asphyxia which has advantages of studying the systemic and regional hemodynamics, oxygen transport with biochemical and pathologic pathways and correlations.

Annually more than 1 million neonates die worldwide as related to asphyxia. Asphyxiated neonates commonly have multi-organ failure including hypotension, ...

Cardiac Stress Test Induced by Dobutamine and Monitored by Cardiac Catheterization in Mice

Dobutamine is a &beta;-adrenergic agonist with an affinity higher for receptor expressed in the heart (&beta;1) than for receptors expressed in the arteries (&beta;2). When systemically administered, it increases cardiac demand. Thus, dobutamine unmasks abnormal rhythm or ischemic areas potentially at risk of infarction. 
Monitoring of heart function during a cardiac stress test can be performed by either ecocardiography or cardiac catheterization. The latter is an invasive but more accurate and informative technique that the former.
Cardiac stress test induced by dobutamine and monitored by cardiac catheterization accomplished as described here allows, in a single experiment, the measurement of the following hemodynamic parameters: heart rate (HR), systolic pressure, diastolic pressure, end-diastolic pressure, maximal positive pressure development (dP/dtmax) and maximal negative pressure development (dP/dtmin), at baseline conditions and under increasing doses of dobutamine.
As expected, in normal mice we observed a dobutamine dose-related increase in HR, dP/dtmax and dP/dtmin. Moreover, at the highest dose tested (12 ng/g/min) the cardiac decompensation of high fat diet-induced obese mice was unmasked.

We describe the protocol to perform a cardiac stress test induced by dobutamine and monitored by cardiac catheterization in normal mice. Also we show its application to unmask subclinical cardiac disease in high fat diet-induced obese mice.

Dobutamine is a &beta;-adrenergic agonist with an affinity higher for receptor expressed in the heart (&beta;1) than for receptors expressed in the ...

Catheterization of the Carotid Artery and Jugular Vein to Perform Hemodynamic Measures, Infusions and Blood Sampling in a Conscious Rat Model

The success of a small animal model to study critical illness is, in part, dependent on the ability of the model to simulate the human condition. Intra-tracheal inoculation of a known amount of bacteria has been successfully used to reproduce the pathogenesis of pneumonia which then develops into sepsis. Monitoring hemodynamic parameters and providing standard clinical treatment including infusion of antibiotics, fluids and drugs to maintain blood pressure is critical to simulate routine supportive care in this model but to do so requires both arterial and venous vascular access. The video details the surgical technique for implanting carotid artery and common jugular vein catheters in an anesthetized rat. Following a 72 hr recovery period, the animals will be re-anesthetized and connected to a tether and swivel setup attached to the rodent housing which connects the implanted catheters to the hemodynamic monitoring system. This setup allows free movement of the rat during the study while continuously monitoring pressures, infusing fluids and drugs (antibiotics, vasopressors) and performing blood sampling.

Vascular accesses to measure hemodynamics, provide fluids and perform blood sampling are important to any small animal model study. We present a technique for implanting catheters into the carotid artery and the common jugular vein in an anesthetized rat for connecting to a system to perform monitoring, infusions and sampling.

The success of a small animal model to study critical illness is, in part, dependent on the ability of the model to simulate the human condition. ...

Carotid Artery Infusions for Pharmacokinetic and Pharmacodynamic Analysis of Taxanes in Mice

When proposing the use of a drug, drug combination, or drug delivery into a novel system, one must assess the pharmacokinetics of the drug in the study model. As the use of mouse models are often a vital step in preclinical drug discovery and drug development1-8, it is necessary to design a system to introduce drugs into mice in a uniform, reproducible manner. Ideally, the system should permit the collection of blood samples at regular intervals over a set time course. The ability to measure drug concentrations by mass-spectrometry, has allowed investigators to follow the changes in plasma drug levels over time in individual mice1, 9, 10. In this study, paclitaxel was introduced into transgenic mice as a continuous arterial infusion over three hours, while blood samples were simultaneously taken by retro-orbital bleeds at set time points. Carotid artery infusions are a potential alternative to jugular vein infusions, when factors such as mammary tumors or other obstructions make jugular infusions impractical. Using this technique, paclitaxel concentrations in plasma and tissue achieved similar levels as compared to jugular infusion. In this tutorial, we will demonstrate how to successfully catheterize the carotid artery by preparing an optimized catheter for the individual mouse model, then show how to insert and secure the catheter into the mouse carotid artery, thread the end of the catheter out through the back of the mouse&#8217;s neck, and hook the mouse to a pump to deliver a controlled rate of drug influx. Multiple low volume retro-orbital bleeds allow for analysis of plasma drug concentrations over time.

This method was developed with the goal of delivering a steady drug solution via the carotid artery, to assess the pharmacokinetics of novel drugs in mouse models.

When proposing the use of a drug, drug combination, or drug delivery into a novel system, one must assess the pharmacokinetics of the drug in the study ...

Ultrasound Assessment of Endothelial-Dependent Flow-Mediated Vasodilation of the Brachial Artery in Clinical Research

The vascular endothelium is a monolayer of cells that cover the interior of blood vessels and provide both structural and functional roles. The endothelium acts as a barrier, preventing leukocyte adhesion and aggregation, as well as controlling permeability to plasma components. Functionally, the endothelium affects vessel tone.
Endothelial dysfunction is an imbalance between the chemical species which regulate vessel tone, thombroresistance, cellular proliferation and mitosis. It is the first step in atherosclerosis and is associated with coronary artery disease, peripheral artery disease, heart failure, hypertension, and hyperlipidemia.
The first demonstration of endothelial dysfunction involved direct infusion of acetylcholine and quantitative coronary angiography. Acetylcholine binds to muscarinic receptors on the endothelial cell surface, leading to an increase of intracellular calcium and increased nitric oxide (NO) production. In subjects with an intact endothelium, vasodilation was observed while subjects with endothelial damage experienced paradoxical vasoconstriction.
There exists a non-invasive, in vivo method for measuring endothelial function in peripheral arteries using high-resolution B-mode ultrasound. The endothelial function of peripheral arteries is closely related to coronary artery function. This technique measures the percent diameter change in the brachial artery during a period of reactive hyperemia following limb ischemia.
This technique, known as endothelium-dependent, flow-mediated vasodilation (FMD) has value in clinical research settings. However, a number of physiological and technical issues can affect the accuracy of the results and appropriate guidelines for the technique have been published. Despite the guidelines, FMD remains heavily operator dependent and presents a steep learning curve. This article presents a standardized method for measuring FMD in the brachial artery on the upper arm and offers suggestions to reduce intra-operator variability.

Endothelial dysfunction is associated with numerous disease states and is predictive of adverse cardiovascular events in humans. Flow-mediated vasodilation (FMD) is a non-invasive ultrasound method of evaluating endothelial function. Methodological choices and operator experience may affect results. A systematic approach to FMD in human studies is discussed here.

The vascular endothelium is a monolayer of cells that cover the interior of blood vessels and provide both structural and functional roles. The ...

Surgical Placement of Catheters for Long-term Cardiovascular Exercise Testing in Swine

This protocol describes the surgical procedure to chronically instrument swine and the procedure to exercise swine on a motor-driven treadmill. Early cardiopulmonary dysfunction is difficult to diagnose, particularly in animal models, as cardiopulmonary function is often measured invasively, requiring anesthesia. As many anesthetic agents are cardiodepressive, subtle changes in cardiovascular function may be masked. In contrast, chronic instrumentation allows for measurement of cardiopulmonary function in the awake state, so that measurements can be obtained under quiet resting conditions, without the effects of anesthesia and acute surgical trauma. Furthermore, when animals are properly trained, measurements can also be obtained during graded treadmill exercise.
Flow probes are placed around the aorta or pulmonary artery for measurement of cardiac output and around the left anterior descending coronary artery for measurement of coronary blood flow. Fluid-filled catheters are implanted in the aorta, pulmonary artery, left atrium, left ventricle and right ventricle for pressure measurement and blood sampling. In addition, a 20 G&#160;catheter is positioned in the anterior interventricular vein to allow coronary venous blood sampling.
After a week of recovery, swine are placed on a motor-driven treadmill, the catheters are connected to pressure and flow meters, and swine are subjected to a five-stage progressive exercise protocol, with each stage lasting 3 min. Hemodynamic signals are continuously recorded and blood samples are taken during the last 30 sec of each exercise stage.
The major advantage of studying chronically instrumented animals is that it allows serial assessment of cardiopulmonary function, not only at rest but also during physical stress such as exercise. Moreover, cardiopulmonary function can be assessed repeatedly during disease development and during chronic treatment, thereby increasing statistical power and hence limiting the number of animals required for a study.

Here we present a protocol to assess cardiopulmonary function in awake swine, at rest and during graded treadmill exercise. Chronic instrumentation allows for repeated hemodynamic measurements uninfluenced by cardiodepressive anesthetic agents.

This protocol describes the surgical procedure to chronically instrument swine and the procedure to exercise swine on a motor-driven treadmill. Early ...

Tachycardia-Induced Cardiomyopathy As a Chronic Heart Failure Model in Swine

A stable and reliable model of chronic heart failure is required for many experiments to understand hemodynamics or to test effects of new treatment methods. Here, we present such a model by tachycardia-induced cardiomyopathy, which can be produced by rapid cardiac pacing in swine.
A single pacing lead is introduced transvenously into fully anaesthetized healthy swine, to the apex of the right ventricle, and fixated. Its other end is then tunneled dorsally to the paravertebral region. There, it is connected to an in-house modified heart pacemaker unit that is then implanted in a subcutaneous pocket. 
After 4 - 8 weeks of rapid ventricular pacing at rates of 200 - 240 beats/min, physical examination revealed signs of severe heart failure - tachypnea, spontaneous sinus tachycardia, and fatigue. Echocardiography and X-ray showed dilation of all heart chambers, effusions, and severe systolic dysfunction. These findings correspond well to decompensated dilated cardiomyopathy and are also preserved after the cessation of pacing.
This model of tachycardia-induced cardiomyopathy can be used for studying the pathophysiology of progressive chronic heart failure, especially hemodynamic changes caused by new treatment modalities like mechanical circulatory supports. This methodology is easy to perform and the results are robust and reproducible.

Here, we present a protocol to produce tachycardia-induced cardiomyopathy in swine. This model represents a potent way to study the hemodynamics of progressive chronic heart failure and the effects of applied treatment.

A stable and reliable model of chronic heart failure is required for many experiments to understand hemodynamics or to test effects of new treatment ...

Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery

Chronic cardiac ischemia that impairs cardiac function, but does not result in infarct, is termed hibernating myocardium (HM). A large clinical subset of coronary artery disease (CAD) patients have HM, which in addition to causing impaired function, puts them at higher risk for arrhythmia and future cardiac events. The standard treatment for this condition is revascularization, but this has been shown to be an imperfect therapy. The majority of pre-clinical cardiac research focuses on infarct models of cardiac ischemia, leaving this subset of chronic ischemia patients largely underserved. To address this gap in research, we have developed a well-characterized and highly reproducible model of hibernating myocardium in swine, as swine are ideal translational models for human heart disease. In addition to creating this unique disease model, we have optimized a clinically relevant treatment model of coronary artery bypass surgery in swine. This allows us to accurately study the effects of bypass surgery on heart disease, as well as investigate additional or alternate therapies. This model surgically induces single vessel stenosis by implanting a constrictor on the left anterior descending (LAD) artery in a young pig. As the pig grows, the constrictor creates a gradual stenosis, resulting in chronic ischemia with impaired regional function, but preserving tissue viability. Following the establishment of the hibernating myocardium phenotype, we perform off-pump coronary artery bypass graft surgery to revascularize the ischemic region, mimicking the gold-standard treatment for patients in the clinic.

This protocol presents a surgical large animal model of chronic, single vessel ischemia that results in regional abnormalities but does not create infarct, known as hibernating myocardium. Following establishment of chronic ischemia, animals are treated with off-pump LIMA-LAD coronary artery bypass graft surgery to revascularize the ischemic tissue.

Chronic cardiac ischemia that impairs cardiac function, but does not result in infarct, is termed hibernating myocardium (HM). A large clinical subset of ...

Middle Cerebral Artery Occlusion Allowing Reperfusion via Common Carotid Artery Repair in Mice

The ischemic stroke is a major cause of adult long-term disability and death worldwide. The current treatments available are limited, with only tissue plasminogen activator (tPA) as an approved drug treatment to target ischemic strokes. Current research in the field of ischemic stroke focuses on better understanding the pathophysiology of stroke, to develop and investigate novel pharmaceutical targets. Reliable experimental stroke models are crucial for the progression of potential treatments. The middle cerebral artery occlusion (MCAO) model is clinically relevant and the most frequently used surgical model of ischemic stroke in rodents. However, the outcomes of this model, such as lesion volume, are associated with high levels of variability, particularly in mice. The alternative MCAO model described here allows the reperfusion of the common carotid artery (CCA) and the increased perfusion of the middle cerebral artery (MCA) territory, using a tissue pad with fibrinogen-based sealant to repair the vessel, and the improved welfare of the mice by avoiding external carotid artery (ECA) ligation. This reduces the reliance on the Circle of Willis, which is known to be highly anatomically variable in mice. Representative data show that using this alternative surgical approach decreases the variability in lesion volumes between the traditional MCAO approach and the alternative approach described here.

Intraluminal filament occlusion of the middle cerebral artery is the most frequently used in vivo model of experimental stroke in rodents. An alternative surgical approach to allow common carotid artery repair is performed here, which allows the reperfusion of the common carotid artery and a full reperfusion to the middle cerebral artery territory.

The ischemic stroke is a major cause of adult long-term disability and death worldwide. The current treatments available are limited, with only tissue ...