Name: a swine model of neonatal asphyxia
Uploaded: 2011-10-11T12:00:00
Description: Watch this Scientific Journal Video about A Swine Model of Neonatal Asphyxia at JoVE.com

The authors would like to thank the Canadian Institutes of Health Research (MOP53116) and the Alberta Heritage Foundation for Medical Research for the operating grant and establishment fund, respectively, to support the development of this experimental model.

1. Anesthesia
<ol>
	<li>Set the flow rate of the anesthetic machine at 2L/min. Connect the exhaust to vacuum suction.</li>
	<li>Charge face mask with anesthetic gas (Isoflurane) at 5% (&tilde;3 min).</li>
	<li>Newborn piglets will be induced with inhaled Isoflurane 5% in 100% oxygen (&tilde;3 min).</li>
	<li>Maintain anesthesia at 2-3% of Isoflurane. Fine adjustment of Isoflurane by 0.5% as appropriate, however, it may range from 0.5 to 5% depending on the condition of piglets.</li>
	<li>Once the vascular access ...

<ol>
	<li>Borke, W. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Increased+myocardial+matrix+metalloproteinases+in+hypoxic+newborn+pigs+during+resuscitation:+effects+of+oxygen+and+carbon+dioxide.">Increased myocardial matrix metalloproteinases in hypoxic newborn pigs during resuscitation: effects of oxygen and carbon dioxide.</a> Eur. J. Clin. Invest. 34, 459-466 (2004).</li><li>Munkeby, B. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Resuscitation+of+hypoxic+piglets+with+100%+O2+increases+pulmonary+metalloproteinases+and+IL-8.">Resuscitation of hypoxic piglets with 100% O2 increases pulmonary metalloproteinases and IL-8.</a> Pediatr. Res. 58, 542-548 (2005).</li><li>Haaland, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Posthypoxic+hypothermia+in+newborn+piglets.">Posthypoxic hypothermia in newborn piglets.</a> Pediatr. Res. 41, 505-512 (1997).</li><li>Haase, E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Resuscitation+with+100%+oxygen+causes+intestinal+glutathione+oxidation+and+reoxygenation+injury+in+asphyxiated+newborn+piglets.">Resuscitation with 100% oxygen causes intestinal glutathione oxidation and reoxygenation injury in asphyxiated newborn piglets.</a> Ann. Surg. 240, 364-373 (2004).</li><li>Stevens, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Resuscitation+with+21%+or+100%+oxygen+is+equally+effective+in+restoring+perfusion+and+oxygen+metabolism+in+hypoxic+newborn+piglet+liver.">Resuscitation with 21% or 100% oxygen is equally effective in restoring perfusion and oxygen metabolism in hypoxic newborn piglet liver.</a> Shock. 27, 657-662 (2007).</li><li>Johnson, S. T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=N-acetylcysteine+improves+the+hemodynamics+and+oxidative+stress+in+hypoxic+newborn+pigs+reoxygenated+with+100%+oxygen.">N-acetylcysteine improves the hemodynamics and oxidative stress in hypoxic newborn pigs reoxygenated with 100% oxygen.</a> Shock. 28, 484-490 (2007).</li><li>Chapados, I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Plasma+cortisol+response+to+ACTH+challenge+in+hypoxic+newborn+piglets+resuscitated+with+21%+and+100%+oxygen.">Plasma cortisol response to ACTH challenge in hypoxic newborn piglets resuscitated with 21% and 100% oxygen.</a> Shock. 33, 519-525 (2010).</li><li>Cheung, P. Y. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Platelet+dysfunction+in+asphyxiated+newborn+piglets+resuscitated+with+21%+and+100%+oxygen.">Platelet dysfunction in asphyxiated newborn piglets resuscitated with 21% and 100% oxygen.</a> Pediatr. Res. 59, 636-640 (2006).</li><li>Martin-Ancel, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Multiple+organ+involvement+in+perinatal+asphyxia.">Multiple organ involvement in perinatal asphyxia.</a> J. Pediatr. 127, 786-793 (1995).</li><li>Swindle, M. M., Smith, A. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparative+anatomy+and+physiology+of+the+pig.">Comparative anatomy and physiology of the pig.</a> Scan. J. Lab. Anim. Sci. Suppl. 25, 11-22 (1998).</li><li>Chapados, I., Cheung, P. Y. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Not+all+models+are+created+equal:+Animal+models+to+study+hypoxic-ischemic+encephalopathy+of+the+newborn.">Not all models are created equal: Animal models to study hypoxic-ischemic encephalopathy of the newborn.</a> Neonatology. 94, 300-303 (2008).</li><li>Liu, J. Q. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effects+of+post-resuscitation+treatment+with+N-acetylcysteine+on+cardiac+recovery+in+hypoxia-injured+newborn+pigs.">Effects of post-resuscitation treatment with N-acetylcysteine on cardiac recovery in hypoxia-injured newborn pigs.</a> PLoS ONE. 5, e15322-e15322 (2010).</li><li>Cheung, P. Y. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cardio-renal+recovery+of+hypoxic+newborn+pigs+after+18%,+21%+and+100%+reoxygenation.">Cardio-renal recovery of hypoxic newborn pigs after 18%, 21% and 100% reoxygenation.</a> Intensive Care Med. 34, 1114-1121 (2008).</li><li>Temesvari, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Modulation+of+the+blood-brain+barrier+permeability+in+neonatal+cytotoxic+brain+edema:+laboratory+and+morphological+findings+obtained+on+newborn+piglets+with+experimental+pneumothorax.">Modulation of the blood-brain barrier permeability in neonatal cytotoxic brain edema: laboratory and morphological findings obtained on newborn piglets with experimental pneumothorax.</a> Biol. Neonate. 46, 198-208 (1984).</li><li>Domoki, F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Reventilation+with+room+air+or+100%+oxygen+after+asphyxia+differentially+affects+cerebral+neuropathology+in+newborn+pigs.">Reventilation with room air or 100% oxygen after asphyxia differentially affects cerebral neuropathology in newborn pigs.</a> Acta. Paediatr. 95, 1109-1115 (2006).</li><li>. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Part+15:+Neonatal+resuscitation:+2010+American+Heart+Association+guidelines+for+cardiopulmonary+resuscitation+and+emergency+cardiovascular+care.">Part 15: Neonatal resuscitation: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care.</a> Circulation. 122, S909-S919 (2010).</li></ol>

The current experimental protocol has an advantage to examine the systemic and regional hemodynamic changes in neonatal subjects during the hypoxia and reoxygenation process. We can also examine the respective effect of interventions used to improve the cardiovascular function during recovery. We and others have reported the experience and findings in the study of neonatal asphyxia regarding the effects in cardiovascular1, pulmonary2, neurologic3, gastrointestinal4, hepatic<sup...

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.

Watch this Scientific Journal Video about A Swine Model of Neonatal Asphyxia at JoVE.com

A Swine Model of Neonatal Asphyxia

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, ...

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