To begin, disinfect the entire anterior neck of an adult anesthetized pig with 2%chlorhexidine scrub, followed by a spray of 5%povidone iodine. Make right-sided vertical incisions immediately lateral to the trachea and extend the incision with monopolar cautery to expose the right external jugular, or EJ, and internal jugular, or IJ veins and internal carotid artery. Employ Kelly tissue scissors and Lahey retractors or tissue forceps to dissect the strap muscles and tract as needed.
Expose the bilateral EJ, IJ, and carotid artery. Using a Seldinger technique, place a 4-French arterial line in the right carotid artery, or CA, for invasive blood pressure monitoring. Next place an 8.5 French cannula into the right EJ or IJ.Using blade number 23, make left side vertical incisions immediately lateral to the trachea to expose the left EJ and IJ veins and left carotid artery.
Using Kelly tissue scissors and Lahey retractors or tissue forceps dissect the strap muscles and tract as needed. Expose the left EJ, IJ, and carotid artery. Next, cannulate the left EJ or IJ with a 14-French cannula and connect it to a dedicated roller pump tubing primed with Plasma-Lyte solution.
Once cannulated, place a 7-French pulmonary artery catheter, or PAC, through the introducer of the right EJ.Monitor the heart rate using telemetry leads. Now connect a pressure transducer attached to a blood pressure amplifier to the CA catheter to monitor the systolic blood pressure, or SBP, diastolic blood pressure, or DBP, and mean arterial pressure, or MAP. Attach a pressure transducer connected to a blood pressure amplifier to the appropriate PAC ports.
Monitor the mean pulmonary artery pressure, or MPAP, systolic pulmonary artery pressure, or SPAP, diastolic pulmonary artery pressure, or DPAP, and central venous pressure, or CVP, on the blood pressure amplifier. Administer Plasma-Lyte through the left EJ at approximately 100 milliliters per minute to obtain a starting pulmonary capillary wedge pressure or PCWP, of 8 to 10 millimeters of mercury before the initiation of acute volume overload.
