Name: repeated orotracheal intubation in mice
Uploaded: 2020-03-27T14:00:00
Description: Watch this Scientific Journal Video about Repeated Orotracheal Intubation in Mice at JoVE.com

The authors thank Lucia Rosas, Lauren Doolittle, Lisa Joseph and Lindsey Ferguson for their technical assistance and the University Laboratory Animal Resources for their animal care support. This work is funded by NIH T35OD010977 and R01-HL102469.

All animal activities described here have been approved by the Institutional Animal Care and Use Committee (IACUC) of The Ohio State University and were conducted in AAALAC-accredited facilities.
1. Procedure Preparation
<ol>
	<li>Construct the intubation platform. To achieve the appropriate platform slope, use a three-inch (7.6 cm) 3-ring binder. Fold a 15&#8722;20 cm length of 3-0 silk or other thread material in half and adhere the ends of the thread to the top of the inclined platform wi...

<ol>
	<li>Spoelstra, E. N., 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=A+novel+and+simple+method+for+endotracheal+intubation+of+mice.">A novel and simple method for endotracheal intubation of mice.</a> Laboratory Animals. 41 (1), 128-135 (2007).</li><li>Rivera, B., Miller, S. R., Brown, E. M., Price, R. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+Novel+Method+for+Endotracheal+Intubation+of+Mice+and+Rats+Used+in+Imaging+Studies.">A Novel Method for Endotracheal Intubation of Mice and Rats Used in Imaging Studies.</a> Contemporary Topics in Laboratory Animal Science. 44 (2), 52-55 (2005).</li><li>Sparrowe, J., Jimenez, M., Rullas, J., Martinez, A. E., Ferrer, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Refined+Intratracheal+Intubation+Technique+in+the+Mouse,+Complete+Protocol+Description+for+Lower+Airway+Models.">Refined Intratracheal Intubation Technique in the Mouse, Complete Protocol Description for Lower Airway Models.</a> Global Journal of Animal Scientific Research. 3 (2), 363-369 (2015).</li><li>Deyo, D. J., Wei, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+Novel+Method+of+Intubation+and+Ventilation+in+Mice.">A Novel Method of Intubation and Ventilation in Mice.</a> Anesthesia &amp; Analgesia. 88 (2), 179 (1999).</li><li>Vergari, 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=A+new+method+of+orotracheal+intubation+in+mice.">A new method of orotracheal intubation in mice.</a> European Review for Medical and Pharmacological Sciences. 8 (3), 103-106 (2004).</li><li>Brown, R. H., Walters, D. M., Greenberg, R. S., Mitzner, W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+method+of+endotracheal+intubation+and+pulmonary+functional+assessment+for+repeated+studies+in+mice.">A method of endotracheal intubation and pulmonary functional assessment for repeated studies in mice.</a> Journal of Applied Physiology. 87 (6), 2362-2365 (1999).</li><li>Das, S., MacDonald, K., Chang, H. S., Mitzner, W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+Simple+Method+of+Mouse+Lung+Intubation.">A Simple Method of Mouse Lung Intubation.</a> Journal of Visualized Experiments. (73), e50318 (2013).</li><li>Limjunyawong, N., Mock, J., Mitzner, W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Instillation+and+Fixation+Methods+Useful+in+Mouse+Lung+Cancer+Research.">Instillation and Fixation Methods Useful in Mouse Lung Cancer Research.</a> Journal of Visualized Experiments. (102), e52964 (2015).</li><li>Qin, W., Baran, U., Wang, W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Lymphatic+response+to+depilation-induced+inflammation+assessed+with+label-free+optical+lymphangiography.">Lymphatic response to depilation-induced inflammation assessed with label-free optical lymphangiography.</a> Lasers in Surgery and Medicine. 47 (8), 669-676 (2015).</li><li>McGovern, T. K., Robichaud, A., Fereydoonzad, L., Schuessler, T. F., Martin, J. G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Evaluation+of+Respiratory+System+Mechanics+in+Mice+using+the+Forced+Oscillation+Technique.">Evaluation of Respiratory System Mechanics in Mice using the Forced Oscillation Technique.</a> Journal of Visualized Experiments. (75), e50107 (2013).</li></ol>

Intubation using the transcutaneous tracheal visualization technique offers a refined approach to the standard skin incision method. With special attention to several key steps, intubation can be easily and quickly achieved. The animal must be placed squarely in dorsal recumbency on the intubation platform with the mouse secured in gentle retraction. This will extend the animal into vertical alignment and proper positioning for intubation. In addition, the depilatory cream should not remain in contact with the animal&#82...

The laboratory mouse is a common animal model for human respiratory disease. Thus, there are several published methods for mouse intubation for the purpose of both instillation of treatments and measurement of respiratory mechanics. Most of the described procedures require visualization of the glottis through the oral cavity with specialized equipment such as a laryngoscope or fiber-optic light source1,2,3,4,5,6,7. However, this can be difficult when a relatively large cannula is required, as it can obscure the view of the researcher. Limjunyawong et al.8 have addressed this concern with a method of intubation in which a small cutaneous incision is made along the midline of the ventral neck allowing for visualization of the trachea. Following the procedure, the incision is closed with tissue adhesive.
For studies requiring frequent repeated intubations, successive incising and closure of this site requires debridement of the skin margins and tissue trauma to the ventral neck. The purpose of the transcutaneous tracheal visualization approach to oral intubation is to provide a refined, noninvasive technique specifically suitable for repeated intubation studies as well as single intubation events in mice.

<table>
	<tbody>
		<tr>
			<td>18Gx1 1/4&#34; intravenous catheter, Safelet</td>
			<td>Fisher Scientific</td>
			<td>#14-841-14</td>
			<td>Cannula for intubation</td>
		</tr>
		<tr>
			<td>70% ethanol, 10L</td>
			<td>Fisher Scientific</td>
			<td>25467025</td>
			<td>Cleaning cannula</td>
		</tr>
		<tr>
			<td>Abrasive paper (sandpaper)</td>
			<td>Porter-Cable</td>
			<td>74001201</td>
			<td>Cannula preparation</td>
		</tr>
		<tr>
			<td>AnaSed (xylazine sterile solution) injection (100 mg/ml)</td>
			<td>Akorn Animal Health</td>
			<td>NDC# 59399-111-50</td>
			<td>Anesthesia</td>
		</tr>
		<tr>
			<td>Blue labeling tape (0.5 in x 14 yds)</td>
			<td>Fisher Scientific</td>
			<td>15966</td>
			<td>Restraint on intubation platform</td>
		</tr>
		<tr>
			<td>Braided silk suture without needle, nonsterile, (3-0)</td>
			<td>Henry Schein</td>
			<td>Item #1007842</td>
			<td>Intubation platform</td>
		</tr>
		<tr>
			<td>Deltaphase Isothermal Pad</td>
			<td>Braintree Scientific</td>
			<td>39DP</td>
			<td>Mouse thermoregulation and recovery</td>
		</tr>
		<tr>
			<td>Deltaphase Operating Board</td>
			<td>Braintree Scientific</td>
			<td>39OP</td>
			<td>Mouse recovery (prior to extubation)</td>
		</tr>
		<tr>
			<td>Distilled water</td>
			<td>ThermoFisher</td>
			<td>15230253</td>
			<td>Cleaning mouse following depilation</td>
		</tr>
		<tr>
			<td>Eye Scissors, angled, sharp/sharp</td>
			<td>Harvard Apparatus</td>
			<td>72-8437</td>
			<td>Cannula preparation</td>
		</tr>
		<tr>
			<td>FlexiVent (FX Module 2)</td>
			<td>Scireq</td>
			<td>N/A</td>
			<td>Record lung function data (not required to perform procedure, used in this study to validate procedure)</td>
		</tr>
		<tr>
			<td>Gauze sponges</td>
			<td>Fisher scientific</td>
			<td>13-761-52</td>
			<td>Hair removal</td>
		</tr>
		<tr>
			<td>Heavy-Duty 3&#34; 3-Ring View Binders</td>
			<td>Staples</td>
			<td>24690CT</td>
			<td>Intubation platform</td>
		</tr>
		<tr>
			<td>Instat Software</td>
			<td>Graphpad</td>
			<td>N/A</td>
			<td>Statistical analysis software</td>
		</tr>
		<tr>
			<td>Insulin syringe (0.5 cc, U100)</td>
			<td>Fisher Scientific</td>
			<td>329461</td>
			<td>Anesthesia administration</td>
		</tr>
		<tr>
			<td>Ketamine HCl Injection, USP (100 mg/ml)</td>
			<td>Llyod Laoratories</td>
			<td>List No. 4871</td>
			<td>Anesthesia</td>
		</tr>
		<tr>
			<td>Lung inflation bulb</td>
			<td>Harvard Apparatus</td>
			<td>72-9083</td>
			<td>Confirm cannula placement</td>
		</tr>
		<tr>
			<td>Micro Forceps, Curved, Smooth</td>
			<td>Harvard Apparatus</td>
			<td>72-0445</td>
			<td>Retract tongue and create tension on neck for cannula visualization</td>
		</tr>
		<tr>
			<td>Nair (hair removal lotion), 9 oz bottle</td>
			<td>Church &#38; Dwight</td>
			<td>42010440</td>
			<td>Hair removal</td>
		</tr>
		<tr>
			<td>Sterile saline (0.9%), 10 ml</td>
			<td>Fisher Scientific</td>
			<td>NC9054335</td>
			<td>Anesthesia, cleaning skin following hair removal</td>
		</tr>
	</tbody>
</table>

repeated orotracheal intubation in mice

The literature describes several methods for mouse intubation that either require visualization of the glottis through the oral cavity or incision in the ventral neck for direct confirmation of cannula placement in the trachea. The relative difficulty or the tissue trauma induced to the subject by such procedures can be an impediment to an investigator&#8217;s ability to perform longitudinal studies. This article illustrates a technique in which physical manipulation of the mouse following the use of a depilatory to remove hair from the ventral neck permits transcutaneous visualization of the trachea for orotracheal intubation regardless of degree of skin pigmentation. This method is innocuous to the subject and easily achieved with a limited understanding of murine anatomy. This refined approach facilitates repeated intubation, which may be necessary for monitoring progression of disease or instillation of treatments. Using this method may result in a reduction of the number of animals and technical skill required to measure lung function in mouse models of respiratory disease.

Serial monitoring of baseline pulmonary function 
Eighteen-week-old female BALB/c and 10-week-old C57BL/6 mice (n = 3 of each strain) were intubated using the described method on day 0, 3, 10, and 17. Following intubation on each day, the subject was connected to a mechanical ventilator supplied with 100% oxygen (Table of Materials). Respiratory resistance (Rrs) was measured using the forced oscillation technique for 60 s following a deep inflation to 25 cm H2O held for 5...

Watch this Scientific Journal Video about Repeated Orotracheal Intubation in Mice at JoVE.com

Repeated Orotracheal Intubation in Mice

The goal of this article is to describe a refined method of intubation of the laboratory mouse. The method is noninvasive and, therefore, ideal for studies that require serial monitoring of respiratory function and/or instillation of treatments into the lung.

The literature describes several methods for mouse intubation that either require visualization of the glottis through the oral cavity or incision in the ...

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