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>
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			<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>
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			<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>
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			<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>
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			<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>
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			<td style="width:123px;">162-11-602</td>
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			<td style="width:122px;">Bayer</td>
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			<td style="width:250px;">DIN:02169606 1 x 50ml bottle</td>
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</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.

Research

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Medicine

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