Name: complete and partial aortic occlusion for the treatment of hemorrhagic shock in swine
Uploaded: 2018-08-24T14:45:00
Description: Watch this Scientific Journal Video about Complete and Partial Aortic Occlusion for the Treatment of Hemorrhagic Shock in Swine at JoVE.com

Vi ønsker å erkjenne Rachel O'Connell, og Jessica Lee for deres hjelp med dyrestudier. Vi ønsker også å erkjenne Major General Harold Timboe, MD, MPH, US Army (pensjonert), som har vært rådgiver og mentor for dette prosjektet.

Etterforskerne overholdt dyr velferd arbeidsmiljølovens forskrifter og andre føderale lover om dyr og eksperimenter som involverer dyr og prinsippene fastsatt i gjeldende versjon av guiden for omsorg og drive forskning ved hjelp av dyr, i forsøksdyr av National Research Council. Denne studien protokollen ble godkjent av University of Michigan institusjonelle Animal Care og bruk Committee (IACUC). Forsøkene ble utført i samsvar med alle regler og retningslinjer for dyrevelferd i forskning.
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<ol>
	<li>Kauvar, D. S., Lefering, R., 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=Impact+of+hemorrhage+on+trauma+outcome:+an+overview+of+epidemiology,+clinical+presentations,+and+therapeutic+considerations.">Impact of hemorrhage on trauma outcome: an overview of epidemiology, clinical presentations, and therapeutic considerations.</a> The Journal of Trauma: Injury, Infection and Critical. 60, S3-S11 (2006).</li><li>Kauvar, D. S., 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=The+epidemiology+and+modern+management+of+traumatic+hemorrhage:+US+and+international+perspectives.">The epidemiology and modern management of traumatic hemorrhage: US and international perspectives.</a> Critical Care. 9, S1-S9 (2005).</li><li>Mattox, K. L., Allen, M. K., Feliciano, D. 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C., 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=Trauma+Association+critical+decisions+in+trauma:+resuscitative+thoracotomy.">Trauma Association critical decisions in trauma: resuscitative thoracotomy.</a> Journal of Trauma and Acute Care Surgery. 73 (6), 1359-1363 (2012).</li><li>DuBose, J. J., 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=The+AAST+prospective+Aortic+Occlusion+for+Resuscitation+in+Trauma+and+Acute+Care+Surgery+(AORTA)+registry:+Data+on+contemporary+utilization+and+outcomes+of+aortic+occlusion+and+resuscitative+balloon+occlusion+of+the+aorta+(REBOA).">The AAST prospective Aortic Occlusion for Resuscitation in Trauma and Acute Care Surgery (AORTA) registry: Data on contemporary utilization and outcomes of aortic occlusion and resuscitative balloon occlusion of the aorta (REBOA).</a> Journal of Trauma and Acute Care Surgery. 81 (3), 409-419 (2016).</li><li>Biffl, W. L., Fox, C. J., Moore, E. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+role+of+REBOA+in+the+control+of+exsanguinating+torso+hemorrhage.">The role of REBOA in the control of exsanguinating torso hemorrhage.</a> Journal of Trauma and Acute Care Surgery. 78 (5), 1054-1058 (2015).</li><li>Manzano Nunez, 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=A+meta-analysis+of+resuscitative+endovascular+balloon+occlusion+of+the+aorta+(REBOA)+or+open+aortic+cross-clamping+by+resuscitative+thoracotomy+in+non-compressible+torso+hemorrhage+patients.">A meta-analysis of resuscitative endovascular balloon occlusion of the aorta (REBOA) or open aortic cross-clamping by resuscitative thoracotomy in non-compressible torso hemorrhage patients.</a> World Journal of Emergency Surgery. 12, 30 (2017).</li><li>Gupta, B. 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=The+role+of+intra-aortic+balloon+occlusion+in+penetrating+abdominal+trauma.">The role of intra-aortic balloon occlusion in penetrating abdominal trauma.</a> Journal of Trauma. 29 (6), 861-865 (1989).</li><li>Inoue, J., 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=Resuscitative+endovascular+balloon+occlusion+of+the+aorta+might+be+dangerous+in+patients+with+severe+torso+trauma:+A+propensity+score+analysis.">Resuscitative endovascular balloon occlusion of the aorta might be dangerous in patients with severe torso trauma: A propensity score analysis.</a> Journal of Trauma and Acute Care Surgery. 80 (4), 559-566 (2016).</li><li>Russo, R. M., 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=Extending+the+golden+hour:+Partial+resuscitative+endovascular+balloon+occlusion+of+the+aorta+in+a+highly+lethal+swine+liver+injury+model.">Extending the golden hour: Partial resuscitative endovascular balloon occlusion of the aorta in a highly lethal swine liver injury model.</a> Journal of Trauma and Acute Care Surgery. 80 (3), 378-380 (2016).</li><li>Russo, R. M., 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=Partial+Resuscitative+Endovascular+Balloon+Occlusion+of+the+Aorta+in+Swine+Model+of+Hemorrhagic+Shock.">Partial Resuscitative Endovascular Balloon Occlusion of the Aorta in Swine Model of Hemorrhagic Shock.</a> Journal of the American College of Surgeons. 223 (2), 359-368 (2016).</li><li>Williams, T. 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=Extending+resuscitative+endovascular+balloon+occlusion+of+the+aorta:+Endovascular+variable+aortic+control+in+a+lethal+model+of+hemorrhagic+shock.">Extending resuscitative endovascular balloon occlusion of the aorta: Endovascular variable aortic control in a lethal model of hemorrhagic shock.</a> The Journal of Trauma and Acute Care Surgery. 81 (2), 294-301 (2016).</li><li>Hannon, J. P., Swindle, M. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Hemorrhage+and+hemorrhagic-shock+in+swine:+A+review.">Hemorrhage and hemorrhagic-shock in swine: A review.</a> Swine as Models in Biomedical Research. , 197-245 (1992).</li><li>Garry, B. P., Bivens, H. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+Seldinger+technique.">The Seldinger technique.</a> Journal of Cardiothorac Anesthesia. 2 (3), 403 (1988).</li><li>Halaweish, I., 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=Addition+of+low-dose+valproic+acid+to+saline+resuscitation+provides+neuroprotection+and+improves+long-term+outcomes+in+a+large+animal+model+of+combined+traumatic+brain+injury+and+hemorrhagic+shock.">Addition of low-dose valproic acid to saline resuscitation provides neuroprotection and improves long-term outcomes in a large animal model of combined traumatic brain injury and hemorrhagic shock.</a> The Journal of Trauma and Acute Care Surgery. 79 (6), 911-919 (2015).</li><li>Alam, H. B., 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=Surviving+blood+loss+without+blood+transfusion+in+a+swine+poly-trauma+model.">Surviving blood loss without blood transfusion in a swine poly-trauma model.</a> Surgery. 146 (2), 325-333 (2009).</li><li>Jin, G., 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=Traumatic+brain+injury+and+hemorrhagic+shock:+evaluation+of+different+resuscitation+strategies+in+a+large+animal+model+of+combined+insults.">Traumatic brain injury and hemorrhagic shock: evaluation of different resuscitation strategies in a large animal model of combined insults.</a> Shock. 38 (1), 49-56 (2012).</li><li>Nikolian, V. C., 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=Valproic+acid+decreases+brain+lesion+size+and+improves+neurologic+recovery+in+swine+subjected+to+traumatic+brain+injury,+hemorrhagic+shock,+and+polytrauma.">Valproic acid decreases brain lesion size and improves neurologic recovery in swine subjected to traumatic brain injury, hemorrhagic shock, and polytrauma.</a> The Journal of Trauma and Acute Care Surgery. 83 (6), 1066-1073 (2017).</li><li>Langeland, H., Lyng, O., Aadahl, P., Skjaervold, N. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+coherence+of+macrocirculation,+microcirculation,+and+tissue+metabolic+response+during+nontraumatic+hemorrhagic+shock+in+swine.">The coherence of macrocirculation, microcirculation, and tissue metabolic response during nontraumatic hemorrhagic shock in swine.</a> Physiological Reports. 5 (7), (2017).</li><li>Johnson, M. 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=The+effect+of+resuscitative+endovascular+balloon+occlusion+of+the+aorta,+partial+aortic+occlusion+and+aggressive+blood+transfusion+on+traumatic+brain+injury+in+a+swine+multiple+injuries+model.">The effect of resuscitative endovascular balloon occlusion of the aorta, partial aortic occlusion and aggressive blood transfusion on traumatic brain injury in a swine multiple injuries model.</a> Journal of Trauma Acute Care Surgery. 83 (1), 61-70 (2017).</li><li>Theisen, M. M., 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=Ventral+recumbency+is+crucial+for+fast+and+safe+orotracheal+intubation+in+laboratory+swine.">Ventral recumbency is crucial for fast and safe orotracheal intubation in laboratory swine.</a> Laboratory Animals. 43 (1), 96-101 (2009).</li><li>Li, Y., Alam, H. B. <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+acetylation:+creating+a+pro-survival+and+anti-inflammatory+phenotype+in+lethal+hemorrhagic+and+septic+shock.">Modulation of acetylation: creating a pro-survival and anti-inflammatory phenotype in lethal hemorrhagic and septic shock.</a> Journal of Biomedicine and Biotechnology. 2011, 523481 (2011).</li><li>Nikolian, V. C., 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=Valproic+acid+decreases+brain+lesion+size+and+improves+neurologic+recovery+in+swine+subjected+to+traumatic+brain+injury,+hemorrhagic+shock,+and+polytrauma.">Valproic acid decreases brain lesion size and improves neurologic recovery in swine subjected to traumatic brain injury, hemorrhagic shock, and polytrauma.</a> The Journal of Trauma and Acute Care Surgery. 83 (6), 1066-1073 (2017).</li><li>Dekker, S. 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=Normal+saline+influences+coagulation+and+endothelial+function+after+traumatic+brain+injury+and+hemorrhagic+shock+in+pigs.">Normal saline influences coagulation and endothelial function after traumatic brain injury and hemorrhagic shock in pigs.</a> Surgery. 156 (3), 556-563 (2014).</li><li>Causey, M. W., McVay, D. P., Miller, S., Beekley, A., Martin, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+efficacy+of+Combat+Gauze+in+extreme+physiologic+conditions.">The efficacy of Combat Gauze in extreme physiologic conditions.</a> The Journal of Surgical Research. 177 (2), 301-305 (2012).</li><li>Frankel, D. 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=Physiologic+response+to+hemorrhagic+shock+depends+on+rate+and+means+of+hemorrhage.">Physiologic response to hemorrhagic shock depends on rate and means of hemorrhage.</a> The Journal of Surgical Research. 143 (2), 276-280 (2007).</li><li>Morrison, J. J., 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=The+inflammatory+sequelae+of+aortic+balloon+occlusion+in+hemorrhagic+shock.">The inflammatory sequelae of aortic balloon occlusion in hemorrhagic shock.</a> The Journal of Surgical Research. 191 (2), 423-431 (2014).</li><li>White, J. M., 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+porcine+model+for+evaluating+the+management+of+noncompressible+torso+hemorrhage.">A porcine model for evaluating the management of noncompressible torso hemorrhage.</a> Journal of Trauma. 71, S131-S138 (2011).</li><li>Alam, H. B., 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=Putting+life+on+hold-for+how+long?+Profound+hypothermic+cardiopulmonary+bypass+in+a+Swine+model+of+complex+vascular+injuries.">Putting life on hold-for how long? Profound hypothermic cardiopulmonary bypass in a Swine model of complex vascular injuries.</a> Journal of Trauma. 64 (4), 912-922 (2008).</li><li>Bebarta, V. S., Daheshia, M., Ross, J. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+significance+of+splenectomy+in+experimental+swine+models+of+controlled+hemorrhagic+shock.">The significance of splenectomy in experimental swine models of controlled hemorrhagic shock.</a> The Journal of Trauma and Acute Care Surgery. 75 (5), 920 (2013).</li><li>Georgoff, P. 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=Alterations+in+the+human+proteome+following+administration+of+valproic+acid.">Alterations in the human proteome following administration of valproic acid.</a> Journal of Trauma and Acute Care Surgery. 81 (6), 1020-1027 (2016).</li><li>Dekker, S. 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I denne protokollen understreket vi hemoragisk sjokk modell på svin. Denne modellen har vist seg å være både pålitelig og reproduserbar16,17,18,19. Modeller som ligner på dette har vært ansatt i flere vitenskapelige studier undersøker virkningene av hemoragisk sjokk på dyr fysiologi16,20. Videre, denne modellen har også blitt ...

Blødning fortsetter å være den dominerende årsaken til forebygges dødsfall i pasienter som gjennomgår traumatiske hendelser, regnskap for 90% av traumer narkotikarelaterte dødsfall i innstillingen militære og 40% av posttraumatisk dødsfall i sivilbefolkningen1, 2. selv om direkte trykk kan behandle Komprimerbar blødning, ikke-Komprimerbar torso blødning fortsatt vanskelig å behandle og kan være dødelig uten spørsmål hemostatic kontroll. Den historiske tilnærmingen resuscitative thoracotomy eller laparotomy med aorta kryss-har vist seg for å være svært invasiv3,4. Denne intervensjonen krever også en komplekse utvalg algoritme å finne kandidatur til pasienter som har gjennomgått traumatisk fornærmelser5.
I de senere årene har det vært en fornyet interesse i en tidligere beskrevet tilnærming-resuscitative endovascular ballong okklusjon av aorta (REBOA)6,7,8. Selv om REBOA har gitt en kortsiktig overlevelse fordeler i blødning, utgjør en langvarig komplett okklusjon av aorta under ballong inflasjon alvorlige bekymringer med uhelbredelig end-orgel iskemi9,10. I et forsøk på å overvinne denne potensielle sykelighet, er alternativ endovascular strategier for å behandle blødning blir utarbeidet. En slik strategi som har sett en økende oppmerksomhet er en delvis okklusjon av aorta11,12. Ideen om delvis aorta ballong okklusjon gir perfusjon av vaskulær senger distale til området av okklusjon, forbedret fysiologiske proksimale aorta kart og en gradvis afterload reduksjon etter ballong deflasjon. Disse endringene i parametere er endringer fysiologiske egenskaper en blødning dyr. Før denne metoden oversettelse til mennesker, fullstendig og delvis aorta ballong okklusjon katetre har gjennomtestet svin modeller hemoragisk sjokk11,12,13.
Svin er brukt i studier innebærer hemoragisk sjokk i mange år. De fleste av de nåværende forståelsen av i Patofysiologien ved hemoragisk sjokk er avledet fra studier som har benyttet dyr modeller, inkludert svin. Deres fysiologi og homøostatisk svar i innstillingen av patologisk volum uttømming følgende blødning, særlig de gjelder blod clotting og hjerte svar, har vært godt dokumentert og er som de i mennesker14. Svin modeller av hemoragisk sjokk også gi muligheter til å undersøke behandling strategier for hemoragisk sjokk og andre traumatiske skader.
I denne studien viser vi en klinisk realistisk modell av hemoragisk sjokk i svin å evaluere endovascular behandling strategier, inkludert fullstendig og delvis aorta ballong okklusjon. Vi hypothesize at en delvis okklusjon av aorta fører til en bedre fysiologiske og laboratoriet profil i forhold til en fullstendig okklusjon av aorta i svin gjennomgår en kontrollert fast volum blødning.
Vi som mål å sammenligne fysiologiske effekter av delvis og total aorta okklusjon som behandling for hemoragisk sjokk i en svin modell. Delvis aorta okklusjon ble oppnådd ved hjelp av en selektiv aorta ballong okklusjon i traumer (SABOT) kateter (figur 1). Den SABOT kateter er en to-ballong-system som tillater intra-luminal blodstrøm, og dermed gir en delvis aorta strøm til vaskulær senger distale til okklusjon. Komplett aorta okklusjon ble oppnådd ved hjelp av en enkelt-ballongen aorta okklusjon kateter (f.eksCODA) (figur 1). Behandlingsgrupper var tilfeldiggjort for å gjennomgå resuscitative aorta okklusjon enten med fullstendig eller delvis aorta ballong okklusjon katetre (n = 2/gruppe).
De viktigste trinnene av modellen inkluderer induksjon av anestesi og intubasjon, vedlikehold av anestesi, instrumentering, 35% TBV blødning (20 min totalt; halvparten over de første 7 min og halvparten over de resterende 13 min), aorta ballong okklusjon og fullblod resuscitation (60 min av okklusjon, 20% fullblod lungeredning i løpet av de siste 20 min på okklusjon), kritiske omsorg overvåking (240 min) med hemodynamic observasjon og eutanasi med vev høsting. Figur 2 viser modellen benyttet i dette eksperimentet.

<table>
	<tbody>
		<tr>
			<td>Yorkshire-Landrace Swine</td>
			<td>Michigan State University Veterinary Farm</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Anesthesia: Telazol</td>
			<td>Pfizer</td>
			<td></td>
			<td>Dose: 2-8 mg/kg; IM</td>
		</tr>
		<tr>
			<td>Anti-cholinergic: Atropine</td>
			<td>Pfizer</td>
			<td></td>
			<td>Dose: 1mg, IM</td>
		</tr>
		<tr>
			<td>Anesthesia: Isoflurane</td>
			<td>Baxter</td>
			<td></td>
			<td>Dose: 1-5%, INH</td>
		</tr>
		<tr>
			<td>Betadine</td>
			<td>Humco</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Alcohol 70%</td>
			<td>Humco</td>
			<td>NDC 0395-4202-28</td>
			<td></td>
		</tr>
		<tr>
			<td>Datex-Aespire Anesthesia Machine</td>
			<td>GE Healthcare</td>
			<td>7900</td>
			<td></td>
		</tr>
		<tr>
			<td>Endotracheal tube</td>
			<td>DEE Veterinary</td>
			<td>20170518</td>
			<td>Appropriate size for animal (6.5 or 7.0F)</td>
		</tr>
		<tr>
			<td>Laryngoscope</td>
			<td>Miller</td>
			<td>85-0045</td>
			<td></td>
		</tr>
		<tr>
			<td>Stylet</td>
			<td>Hudson RCI</td>
			<td>5-151--1</td>
			<td></td>
		</tr>
		<tr>
			<td>Jelco 20G IV Catheter</td>
			<td>Smiths Medical</td>
			<td>4054</td>
			<td></td>
		</tr>
		<tr>
			<td>Operating Room Monitor (Vital Signs Monitor)</td>
			<td>SurgiVet Advisor</td>
			<td>V9201</td>
			<td>May require at least 2</td>
		</tr>
		<tr>
			<td>Surgical Gowns</td>
			<td>Kimberly Clark</td>
			<td>90142</td>
			<td>Use appropriate size for surgeon.</td>
		</tr>
		<tr>
			<td>Sterile surgical gloves</td>
			<td>Cardinal Health (Allegiance)</td>
			<td>22537-570</td>
			<td>Use appropriate size for surgeon.</td>
		</tr>
		<tr>
			<td>Cautery Pencil</td>
			<td>Medline</td>
			<td>ESPB 2000</td>
			<td></td>
		</tr>
		<tr>
			<td>Suction tubing</td>
			<td>Medline</td>
			<td>DYND50251</td>
			<td></td>
		</tr>
		<tr>
			<td>Sunction tip: Yankauer</td>
			<td>Medline</td>
			<td>DYND50130</td>
			<td></td>
		</tr>
		<tr>
			<td>Bovie Aaron 1250 Electrocautery Unit</td>
			<td>Bovie Medical Co. FL</td>
			<td>BOV-A1250U</td>
			<td></td>
		</tr>
		<tr>
			<td>Salpel Blade - Size #10</td>
			<td>Cardinal Health (Allegiance)</td>
			<td>32295-010</td>
			<td></td>
		</tr>
		<tr>
			<td>Scalpel Handle</td>
			<td>Martin</td>
			<td>10-295-11</td>
			<td></td>
		</tr>
		<tr>
			<td>Debakey Forceps</td>
			<td>Roboz</td>
			<td>RS-7562</td>
			<td></td>
		</tr>
		<tr>
			<td>Weitlander Retractor</td>
			<td>Roboz</td>
			<td>RS-8612</td>
			<td></td>
		</tr>
		<tr>
			<td>Mayo Scissors</td>
			<td>Roboz</td>
			<td>RS-76870SC</td>
			<td></td>
		</tr>
		<tr>
			<td>Army-navy Retractor</td>
			<td>Teleflex</td>
			<td>164715</td>
			<td></td>
		</tr>
		<tr>
			<td>Mixter Right-angle Forceps</td>
			<td>Teleflex</td>
			<td>175073</td>
			<td></td>
		</tr>
		<tr>
			<td>5F (1.7 mm) 11 cm Insertion Sheath with 0.35&#34; Guidewire</td>
			<td>Boston Scientific</td>
			<td>16035-05B</td>
			<td></td>
		</tr>
		<tr>
			<td>8F (2.7 mm) 11 cm Insertion Sheath with 0.35&#39;&#39; Guidewire</td>
			<td>Boston Scientific</td>
			<td>16035-08B</td>
			<td></td>
		</tr>
		<tr>
			<td>20G angled Introducer Needle</td>
			<td>Arrow</td>
			<td>AK-09903-S</td>
			<td></td>
		</tr>
		<tr>
			<td>14F (4.78 mm) 13 cm Insertion Sheath with 10F dilator</td>
			<td>Cook Medical</td>
			<td>G08024</td>
			<td></td>
		</tr>
		<tr>
			<td>2-0 Silk 18&#39;&#39; 45 cm</td>
			<td>Ethicon</td>
			<td>A185H</td>
			<td></td>
		</tr>
		<tr>
			<td>3-0 Vicryl 36&#39;&#39; 90 cm</td>
			<td>Ethicon</td>
			<td>J344H</td>
			<td></td>
		</tr>
		<tr>
			<td>3-0 Nylon 18&#39;&#39; 45 cm</td>
			<td>Ethicon</td>
			<td>663G</td>
			<td></td>
		</tr>
		<tr>
			<td>4-0 Prolene 30&#39;&#39; 75 cm</td>
			<td>Ethicon</td>
			<td>8831H</td>
			<td></td>
		</tr>
		<tr>
			<td>20 ml syringe</td>
			<td>Metronic/Covidien</td>
			<td>8881512878</td>
			<td></td>
		</tr>
		<tr>
			<td>3 mL syringe</td>
			<td>Metronic/Covidien</td>
			<td>1180300555</td>
			<td></td>
		</tr>
		<tr>
			<td>6 mL syringe</td>
			<td>Metronic/Covidien</td>
			<td>1180600777</td>
			<td></td>
		</tr>
		<tr>
			<td>1000ml 0.9% Saline</td>
			<td>Baxter</td>
			<td>2B1324X</td>
			<td></td>
		</tr>
		<tr>
			<td>Foley Catheter (18F 30 cc)</td>
			<td>Bard</td>
			<td>0166V18S</td>
			<td></td>
		</tr>
		<tr>
			<td>Urinary Drainage Bag</td>
			<td>Bard</td>
			<td>154002</td>
			<td></td>
		</tr>
		<tr>
			<td>9F 10 cm Insertion Sheath</td>
			<td>Arrow</td>
			<td>AK-09903-S</td>
			<td></td>
		</tr>
		<tr>
			<td>Swan-Ganz pulmonary artery catheter (8F)</td>
			<td>Edwards Lifesciences co. CA</td>
			<td>746F8</td>
			<td></td>
		</tr>
		<tr>
			<td>Carotid Flow Probe System</td>
			<td>Transonic, Ithaca, NY</td>
			<td></td>
			<td>3, 4, or 6 mm probes</td>
		</tr>
		<tr>
			<td>SABOT catheter</td>
			<td>Hayes Inc.</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>CODA balloon catheter</td>
			<td>Cook Medical</td>
			<td>8379144</td>
			<td></td>
		</tr>
		<tr>
			<td>Ultrasound, M-Turbo</td>
			<td>SonoSite</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Amplatz Stiff Guidewire (0.035 inch, 260 cm)</td>
			<td>Cook Medical</td>
			<td>G03460</td>
			<td></td>
		</tr>
		<tr>
			<td>Arterial Blood Gas Syringes</td>
			<td>Smiths Medical</td>
			<td>4041-2</td>
			<td></td>
		</tr>
		<tr>
			<td>Arterial Blood Gas Analyzer</td>
			<td>Nova Biochemical</td>
			<td>ABL800</td>
			<td></td>
		</tr>
		<tr>
			<td>Masterflex Pump</td>
			<td>Cole Palmer</td>
			<td>HV-77921-75</td>
			<td></td>
		</tr>
		<tr>
			<td>Blood Collection Bags</td>
			<td>Terumo</td>
			<td>1BBD606A</td>
			<td></td>
		</tr>
		<tr>
			<td>Macro IV drip set</td>
			<td>Hospira</td>
			<td>12672-28</td>
			<td></td>
		</tr>
		<tr>
			<td>Pentobarbital</td>
			<td>Pfizer</td>
			<td></td>
			<td>Dose: 100 mg/kg; IV</td>
		</tr>
		<tr>
			<td>Eppendorf Tubes</td>
			<td>Sorenson</td>
			<td>11590</td>
			<td></td>
		</tr>
		<tr>
			<td>50 cc conical tubes</td>
			<td>Falcon</td>
			<td>352097</td>
			<td></td>
		</tr>
		<tr>
			<td>Formalin</td>
			<td>Fisherbrand</td>
			<td>431121</td>
			<td></td>
		</tr>
		<tr>
			<td>Bair Hugger Normothermia System</td>
			<td>Arizant Healthcare, Inc.</td>
			<td></td>
			<td></td>
		</tr>
	</tbody>
</table>

complete and partial aortic occlusion for the treatment of hemorrhagic shock in swine

Blødning er den ledende årsaken til forebygges dødsfall i traumer. Endovascular behandling av ikke-Komprimerbar torso blødning har vært i forkant av traumer omsorg de siste årene. Siden fullstendig aorta okklusjon presenterer alvorlig bekymring, har begrepet delvis aorta okklusjon fått en økende oppmerksomhet. Her presenterer vi en stor dyr modell av hemoragisk sjokk å undersøke virkningene av en roman delvis aorta ballong okklusjon kateter og sammenligne den med et kateter som fungerer på prinsipper for fullført aorta okklusjon. Svin er anesthetized og instrumentert for å gjennomføre kontrollerte fast volum blødning, og hemodynamic og fysiologiske parametere overvåkes. Etter blødningen aorta ballong okklusjon katetre satt inn og oppblåste i supraceliac aorta for 60 min, der dyrene motta fullblod lungeredning som 20% av total blodvolum (TBV). Etter ballong deflasjon overvåkes dyrene i kritiske omsorg omgivelser 4 h, hvor de får væske lungeredning og vasopressors etter behov. Delvis aorta ballong okklusjon viste forbedret distale mener arteriell Press (kart) under ballong inflasjonen, redusert markører for iskemi og redusert væske lungeredning og vasopressor bruk. Som svin fysiologi og homøostatisk svar etter blødning er godt dokumentert og er som de i mennesker, svin hemoragisk kan sjokk modell brukes til å teste ulike behandling strategier. I tillegg til å behandle blødning, blitt aorta ballong okklusjon katetre populær for sin rolle i hjertestans, cardiac og vaskulær kirurgi og andre høyrisiko valgfag kirurgiske prosedyrer.

Hemodynamic og fysiologiske parametere:
KARTET redusert umiddelbart etter blødning (tall 3A - 3D). I fasen for inflasjon ballong opplevde dyr i gruppen komplett okklusjon høyere proksimale kart sammenlignet med dyrene i gruppen delvis okklusjon (tall 3A og 3B). Gjennomsnittlig distale kartet under ballong Inflasjonen var høyere i gruppen delvis okklusjon sammenl...

Watch this Scientific Journal Video about Complete and Partial Aortic Occlusion for the Treatment of Hemorrhagic Shock in Swine at JoVE.com

Complete and Partial Aortic Occlusion for the Treatment of Hemorrhagic Shock in Swine

Her presenterer vi en protokoll demonstrere en hemoragisk sjokk modell i svin som bruker aorta okklusjon som en bro til definitive omsorg i traumer. Denne modellen har programmet testing en rekke kirurgiske og farmakologiske strategier.

Fullstendig og delvis aorta okklusjon for behandling av hemoragisk sjokk i svin

Hemorrhage remains the leading cause of preventable deaths in trauma. Endovascular management of non-compressible torso hemorrhage has been at the ...

Research

JoVE Journal

Medicine

Fixed Volume or Fixed Pressure: A Murine Model of Hemorrhagic Shock

It is common knowledge that severe blood loss and traumatic injury can lead to a cascade of detrimental signaling events often resulting in mortality. 1, ...

Permanent Cerebral Vessel Occlusion via Double Ligature and Transection

Permanent Cerebral Vessel Occlusion via Double Ligature and Transection

Permanent Cerebral Vessel Okklusjon<em&gt; Via</em&gt; Dobbel Ligatur og transection

Stroke is a leading cause of death, disability, and socioeconomic loss worldwide. The majority of all strokes result from an interruption in blood flow ...

Network Analysis of Foramen Ovale Electrode Recordings in Drug-resistant Temporal Lobe Epilepsy Patients

Network Analyse av foramen ovale elektrode Recordings i resistent tinninglappen epilepsipasienter

Approximately 30% of epilepsy patients are refractory to antiepileptic drugs. In these cases, surgery is the only alternative to eliminate/control ...

2-Methacryloyloxyethyl Phosphorylcholine Polymer Treatment of Complete Dentures to Inhibit Denture Plaque Deposition

2-Metakryloyloksyetylsuccinat phosphorylcholine Polymer Behandling av Komplett Proteser å hemme protese avleiring

Removable dentures made of poly (methyl methacrylate) (PMMA) are prone to bacterial adherence and dental plaque formation, which is called denture plaque. ...

Uncontrolled Hemorrhagic Shock Modeled via Liver Laceration in Mice with Real Time Hemodynamic Monitoring

Ukontrollert hemoragisk sjokk modellert via leverlakerering i mus med realtids hemodynamisk overvåking

Uncontrolled hemorrhage is an important cause of preventable deaths among trauma patients. We have developed a murine model of uncontrolled hemorrhage via ...

Reproducible Motor Deficit Following Aortic Occlusion in a Rat Model Of Spinal Cord Ischemia

Reproducerbart motordefekt etter aortaoklusjon i rottemodell av ryggradssjikt

Spinal cord ischemia is a fatal complication following thoracoabdominal aortic aneurysm surgery. Researchers can investigate the strategies for preventing ...

Standardized Hemorrhagic Shock Induction Guided by Cerebral Oximetry and Extended Hemodynamic Monitoring in Pigs

Standardisert hemoragisk Shock induksjon guidet av cerebral Oksymetri og utvidet hemodynamisk overvåking i griser

Hemorrhagic shock ranks among the main reasons for severe injury-related death. The loss of circulatory volume and oxygen carriers can lead to an ...

Establishing a Swine Model of Post-myocardial Infarction Heart Failure for Stem Cell Treatment

Etablere en svinemodell av post-hjerteinfarkt hjertesvikt for stamcellebehandling

Although advances have been achieved in the treatment of heart failure (HF) following myocardial infarction (MI), HF following MI remains one of the major ...

Complete and Partial Resuscitative Endovascular Balloon Occlusion of the Aorta for Hemorrhagic Shock

Fullstendig og delvis resuscitativ endovaskulær ballongokklusjon av aorta for hemorragisk sjokk

Resuscitative endovascular balloon occlusion of the aorta (REBOA) devices grew out of a military-civilian partnership to develop new capabilities for ...

Ascending Aortic Banding for Studying Pressure-Overload Induced Heart Failure

A Minimally Invasive Model of Aortic Stenosis in Swine

Development of a Minimally Invasive Large-Animal Model for Reliable and Reproducible Cardiovascular Research (Video) | JoVE

En minimalt invasiv modell av aortastenose hos svin

Large animal models of heart failure play an essential role in the development of new therapeutic interventions due to their size and physiological ...