Name: pre-clinical model of cardiac donation after circulatory death
Uploaded: 2019-08-02T13:30:00
Description: Watch this Scientific Journal Video about Pre-clinical Model of Cardiac Donation after Circulatory Death at JoVE.com

这项工作的部分内容得到了马塞尔基金会和罗兰·戈塞林基金会和斯特凡·福米基金会的慷慨捐助的支持。尼古拉斯·诺雷克斯是FRQ-S的学者。
作者们感谢乔希·卓乐·黄、加布里埃尔·加斯康、索菲亚·吉亚西和凯瑟琳·斯卡拉布里尼在数据收集方面的支持。

所有动物护理和实验规程均符合《实验室动物护理和使用指南》,并经蒙特利尔大学研究中心动物护理和使用中心机构动物护理和使用委员会批准。
1. 初步准备工作
<ol><li>打开水浴加热心痛输送系统(图1A)和兰根多夫前体内灌注系统(图1B)。将水温设置为 38.5 °C,溶液温度为 37°C。设置照片可以在补充图1A,B中看到。</li>
	<...

<ol>
	<li>Gass, A. L., 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=Cardiac+Transplantation+in+the+New+Era.">Cardiac Transplantation in the New Era.</a> Cardiology in Review. 23 (4), 182-188 (2015).</li><li>von Dossow, V., Costa, J., D'Ovidio, F., Marczin, N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Worldwide+trends+in+heart+and+lung+transplantation:+Guarding+the+most+precious+gift+ever.">Worldwide trends in heart and lung transplantation: Guarding the most precious gift ever.</a> Best Practice &amp; Research. Clinical Anaesthesiology. 31 (2), 141-152 (2017).</li><li>Hornby, K., Ross, H., Keshavjee, S., Rao, V., Shemie, S. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Non-utilization+of+hearts+and+lungs+after+consent+for+donation:+a+Canadian+multicentre+study.">Non-utilization of hearts and lungs after consent for donation: a Canadian multicentre study.</a> Canadian Journal Of Anaesthesia. 53 (8), 831-837 (2006).</li><li>Manyalich, M., Nelson, H., Delmonico, F. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+need+and+opportunity+for+donation+after+circulatory+death+worldwide.">The need and opportunity for donation after circulatory death worldwide.</a> Current Opinion In Organ Transplantation. 23 (1), 136-141 (2018).</li><li>Shemie, S. D., 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=National+recommendations+for+donation+after+cardiocirculatory+death+in+Canada:+Donation+after+cardiocirculatory+death+in+Canada.">National recommendations for donation after cardiocirculatory death in Canada: Donation after cardiocirculatory death in Canada.</a> CMAJ : Canadian Medical Association Journal. 175 (8), S1 (2006).</li><li>Page, A., Messer, S., Large, S. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Heart+transplantation+from+donation+after+circulatory+determined+death.">Heart transplantation from donation after circulatory determined death.</a> Annals of Cardiothoracic Surgery. 7 (1), 75-81 (2018).</li><li>Monteagudo Vela, M., Garcia Saez, D., Simon, A. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Current+approaches+in+retrieval+and+heart+preservation.">Current approaches in retrieval and heart preservation.</a> Annals of Cardiothoracic Surgery. 7 (1), 67-74 (2018).</li><li>Dhital, K. K., Chew, H. C., Macdonald, P. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Donation+after+circulatory+death+heart+transplantation.">Donation after circulatory death heart transplantation.</a> Current Opinion In Organ Transplantation. 22 (3), 189-197 (2017).</li><li>McNally, S. J., Harrison, E. M., Wigmore, S. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ethical+considerations+in+the+application+of+preconditioning+to+solid+organ+transplantation.">Ethical considerations in the application of preconditioning to solid organ transplantation.</a> Journal of Medical Ethics. 31 (11), 631-634 (2005).</li><li>Rao, V., Feindel, C. M., Weisel, R. D., Boylen, P., Cohen, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Donor+blood+perfusion+improves+myocardial+recovery+after+heart+transplantation.">Donor blood perfusion improves myocardial recovery after heart transplantation.</a> The Journal of Heart and Lung Transplantation. 16 (6), 667-673 (1997).</li><li>Ramzy, D., 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=Cardiac+allograft+preservation+using+donor-shed+blood+supplemented+with+L-arginine.">Cardiac allograft preservation using donor-shed blood supplemented with L-arginine.</a> The Journal of Heart and Lung Transplantation. 24 (10), 1665-1672 (2005).</li><li>Xin, L., 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+Multi-Mode+Perfusion+System+for+Ex+vivo+Heart+Perfusion+Study.">A New Multi-Mode Perfusion System for Ex vivo Heart Perfusion Study.</a> Journal of Medical Systems. 42 (2), 25 (2017).</li><li>Messer, S., Ardehali, A., Tsui, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Normothermic+donor+heart+perfusion:+current+clinical+experience+and+the+future.">Normothermic donor heart perfusion: current clinical experience and the future.</a> Transplant International. 28 (6), 634-642 (2015).</li><li>Flecknell, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Laboratory Animal Anaesthesia (Fourth Edition). , 77-108 (2016).</li><li>Kearns, M. 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=A+Rodent+Model+of+Cardiac+Donation+After+Circulatory+Death+and+Novel+Biomarkers+of+Cardiac+Viability+During+Ex+vivo+Heart+Perfusion.">A Rodent Model of Cardiac Donation After Circulatory Death and Novel Biomarkers of Cardiac Viability During Ex vivo Heart Perfusion.</a> Transplantation. 101 (8), e231-e239 (2017).</li><li>Sandha, J. 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=Steroids+Limit+Myocardial+Edema+During+Ex+vivo+Perfusion+of+Hearts+Donated+After+Circulatory+Death.">Steroids Limit Myocardial Edema During Ex vivo Perfusion of Hearts Donated After Circulatory Death.</a> The Annals of Thoracic Surgery. 105 (6), 1763-1770 (2018).</li><li>Iyer, 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=Increasing+the+tolerance+of+DCD+hearts+to+warm+ischemia+by+pharmacological+postconditioning.">Increasing the tolerance of DCD hearts to warm ischemia by pharmacological postconditioning.</a> American Journal of Transplantation. 14 (8), 1744-1752 (2014).</li><li>Sanz, M. 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=Cardioprotective+reperfusion+strategies+differentially+affect+mitochondria:studies+in+an+isolated+rat+heart+model+of+donation+after+circulatory+death+(DCD).">Cardioprotective reperfusion strategies differentially affect mitochondria:studies in an isolated rat heart model of donation after circulatory death (DCD).</a> American Journal of Transplantation. , (2018).</li><li>Van de Wauwer, 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=The+mode+of+death+in+the+non-heart-beating+donor+has+an+impact+on+lung+graft+quality.">The mode of death in the non-heart-beating donor has an impact on lung graft quality.</a> European Journal of Cardio-Thoracic Surgery. 36 (5), 919-926 (2009).</li><li>Quader, 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=Determination+of+Optimal+Coronary+Flow+for+the+Preservation+of+&amp;#34;Donation+after+Circulatory+Death&amp;#34;+in+Murine+Heart+Model.">Determination of Optimal Coronary Flow for the Preservation of &amp;#34;Donation after Circulatory Death&amp;#34; in Murine Heart Model.</a> ASAIO journal (American Society for Artificial Internal Organs : 1992). 64 (2), 225-231 (2018).</li><li>Priebe, H. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+acute+open-chest+model.">The acute open-chest model.</a> British Journal Of Anaesthesia. 60 (8 Suppl 1), 38-41 (1988).</li><li>Narita, 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=Cardiac+effects+of+vecuronium+and+its+interaction+with+autonomic+nervous+system+in+isolated+perfused+canine+hearts.">Cardiac effects of vecuronium and its interaction with autonomic nervous system in isolated perfused canine hearts.</a> Journal of Cardiovascular Pharmacology. 19 (6), 1000-1008 (1992).</li><li>Dhital, K. 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=Adult+heart+transplantation+with+distant+procurement+and+ex-vivo+preservation+of+donor+hearts+after+circulatory+death:+a+case+series.">Adult heart transplantation with distant procurement and ex-vivo preservation of donor hearts after circulatory death: a case series.</a> Lancet (London, England). 385 (9987), 2585-2591 (2015).</li><li>Messer, S. 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=Functional+assessment+and+transplantation+of+the+donor+heart+after+circulatory+death.">Functional assessment and transplantation of the donor heart after circulatory death.</a> The Journal of Heart and Lung Transplantation. 35 (12), 1443-1452 (2016).</li><li>White, C. W., 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=Assessment+of+donor+heart+viability+during+ex+vivo+heart+perfusion.">Assessment of donor heart viability during ex vivo heart perfusion.</a> Canadian Journal of Physiology and Pharmacology. 93 (10), 893-901 (2015).</li><li>Mayr, 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=Cardiac+troponin+T+and+creatine+kinase+predict+mid-term+infarct+size+and+left+ventricular+function+after+acute+myocardial+infarction:+a+cardiac+MR+study.">Cardiac troponin T and creatine kinase predict mid-term infarct size and left ventricular function after acute myocardial infarction: a cardiac MR study.</a> Journal of Magnetic Resonance Imaging. 33 (4), 847-854 (2011).</li><li>Remppis, 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=Intracellular+compartmentation+of+troponin+T:+release+kinetics+after+global+ischemia+and+calcium+paradox+in+the+isolated+perfused+rat+heart.">Intracellular compartmentation of troponin T: release kinetics after global ischemia and calcium paradox in the isolated perfused rat heart.</a> Journal of Molecular and Cellular Cardiology. 27 (2), 793-803 (1995).</li><li>Rossello, X., Hall, A. R., Bell, R. M., Yellon, D. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Characterization+of+the+Langendorff+Perfused+Isolated+Mouse+Heart+Model+of+Global+Ischemia-Reperfusion+Injury:+Impact+of+Ischemia+and+Reperfusion+Length+on+Infarct+Size+and+LDH+Release.">Characterization of the Langendorff Perfused Isolated Mouse Heart Model of Global Ischemia-Reperfusion Injury: Impact of Ischemia and Reperfusion Length on Infarct Size and LDH Release.</a> Journal of Cardiovascular Pharmacology and Therapeutics. 21 (3), 286-295 (2016).</li><li>Dornbierer, 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=Early+reperfusion+hemodynamics+predict+recovery+in+rat+hearts:+a+potential+approach+towards+evaluating+cardiac+grafts+from+non-heart-beating+donors.">Early reperfusion hemodynamics predict recovery in rat hearts: a potential approach towards evaluating cardiac grafts from non-heart-beating donors.</a> PloS One. 7 (8), e43642 (2012).</li><li>Henry, P. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Positive+staircase+effect+in+the+rat+heart.">Positive staircase effect in the rat heart.</a> The American Journal of Physiology. 228 (2), 360-364 (1975).</li><li>Markert, 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=Evaluation+of+a+method+to+correct+the+contractility+index+LVdP/dt(max)+for+changes+in+heart+rate.">Evaluation of a method to correct the contractility index LVdP/dt(max) for changes in heart rate.</a> Journal of Pharmacological and Toxicological Methods. 66 (2), 98-105 (2012).</li><li>Azar, T., Sharp, J., Lawson, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Heart+rates+of+male+and+female+Sprague-Dawley+and+spontaneously+hypertensive+rats+housed+singly+or+in+groups.">Heart rates of male and female Sprague-Dawley and spontaneously hypertensive rats housed singly or in groups.</a> Journal of the American Association for Laboratory Animal Science. 50 (2), 175-184 (2011).</li><li>Bonney, S., Hughes, K., Eckle, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Anesthetic+cardioprotection:+the+role+of+adenosine.">Anesthetic cardioprotection: the role of adenosine.</a> Current Pharmaceutical Design. 20 (36), 5690-5695 (2014).</li><li>Ali, A. 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这里提出的协议介绍了一个简单,方便和多功能的心脏DCD模型,提供了机会,以评估心脏功能恢复,组织损伤和使用后心形保护剂,以改善捐赠者的恢复心脏否则被丢弃移植。Ex vivo 心脏灌注系统 (EVHP) 系统经过优化,为评估心脏功能提供了一个平台,并提供独特的机会来提供和测试经过改进的解决方案,并辅以后调理药理剂保存和修复DCD心脏在小15和大动物16,17模型的心脏DCD。...

固体器官移植,特别是心脏移植,在全球呈上升趋势。"器官采购的标准方法是脑死亡后捐赠(DBD)。鉴于DBD的严格包容标准,只有不到40%的被录取的心被接受3,从而限制了在面对不断增长的需求和扩大器官等待名单的报价。为了解决这个问题,使用循环死亡后捐赠的器官(DCD)被认为是一个潜在的解决方案4。
然而,在DCD捐赠者中,在戒断护理后出现一个前发期,以及复苏前一段未受保护的温暖缺血期是不可避免的。循环死亡后潜在的器官损伤可能导致器官功能障碍,这解释了人们不愿意常规地采用DCD心脏移植。据报道,只有4个中心使用DCD心脏临床,与严格的标准,包括很短的温暖缺血时间和年轻的捐赠者没有慢性病理6,7。出于伦理和法律原因,在循环死亡5、8、9之前,对捐献者可以进行有限或没有心脏保护干预。因此,任何缓解缺血性再灌注(IR)损伤的缓解措施仅限于在用心电图溶液进行早期再灌注期间启动的心脏病保护疗法,并且不允许进行适当的功能评估。外体心脏灌注(EVHP)和修复DCD心脏使用专用平台已被提出作为替代解决方案,并研究由各种学者10,11,12,13.EVHP 提供了一个独特的机会,将后调理剂交付给 DCD 心脏,以改善功能恢复。然而,为了有效的临床翻译,许多技术和实际问题仍有待解决,而由于缺乏一系列灌注和功能标准来确定可移植性,情况进一步复杂化了。 8.
本文报告开发一种可重复的临床前小动物DCD协议,结合一个体外心脏灌注系统,可用于研究在采购时,在初始再灌注期间启动的器官后调节,以及/或在整个 EVHP 中。

<table>
	<tbody>
		<tr>
			<td>0,9% Sodium Chloride. 1L bag</td>
			<td>Baxter</td>
			<td></td>
			<td>Electrolyte solution for flushing in the modified Langendorff system.</td>
		</tr>
		<tr>
			<td>14G 2&#34; I.V catheter</td>
			<td>Jelco</td>
			<td>4098</td>
			<td>To act as endotracheal tube.</td>
		</tr>
		<tr>
			<td>2,3,5-Triphenyltetrazolium chloride</td>
			<td>Milipore-Sigma</td>
			<td>T8877</td>
			<td>Vital coloration</td>
		</tr>
		<tr>
			<td>22G 1&#34; I.V catheter</td>
			<td>BD</td>
			<td>383532</td>
			<td>I.V catheter with extension tube that facilitates manipulation for carotid catheterization</td>
		</tr>
		<tr>
			<td>Adson Dressing Fcp, 4 3/4&#34;, Serr</td>
			<td>Skalar</td>
			<td>50-3147</td>
			<td>Additional forceps for tissue manipulation</td>
		</tr>
		<tr>
			<td>Alm Self-retaining retractor 4x4 Teeth Blunt 2-3/4&#34;</td>
			<td>Skalar</td>
			<td>22-9027</td>
			<td>Tissue retractor used to maintain the chest open.</td>
		</tr>
		<tr>
			<td>Bridge amp</td>
			<td>ADinstruments</td>
			<td>FE221</td>
			<td>Bridge amp for intracarotid blood pressure measurement</td>
		</tr>
		<tr>
			<td>Calcium chloride</td>
			<td>Milipore-Sigma</td>
			<td>C1016</td>
			<td>CaCl2 anhydrous, granular, &#8804;7.0 mm, &#8805;93.0% Part of the Krebs solution</td>
		</tr>
		<tr>
			<td>D-(+)-Glucose</td>
			<td>Milipore-Sigma</td>
			<td>G8270</td>
			<td>D-Glucose &#8805;99.5% Part of the Krebs solution</td>
		</tr>
		<tr>
			<td>DIN(8) to Disposable BP Transducer</td>
			<td>ADinstruments</td>
			<td>MLAC06</td>
			<td>Adapter cable for link between bridge amp and pressure transducer</td>
		</tr>
		<tr>
			<td>Disposable BP Transducer (stopcock)</td>
			<td>ADinstruments</td>
			<td>MLT0670</td>
			<td>Pressure transducer for intracarotid blood pressure measurement</td>
		</tr>
		<tr>
			<td>dPBS</td>
			<td>Gibco</td>
			<td>14190-144</td>
			<td>Electrolyte solution without calcium or magnesium.</td>
		</tr>
		<tr>
			<td>Eye Dressing Fcp, Str, Serr, 4&#34;</td>
			<td>Skalar</td>
			<td>66-2740</td>
			<td>Additional forceps for tissue manipulation</td>
		</tr>
		<tr>
			<td>Formalin solution, neutral buffered, 10%</td>
			<td>Milipore-Sigma</td>
			<td>HT501128</td>
			<td>Fixative solution</td>
		</tr>
		<tr>
			<td>Heating Pad</td>
			<td>Sunbean</td>
			<td>756-CN</td>
			<td></td>
		</tr>
		<tr>
			<td>Heparin sodium 1000 UI/mL</td>
			<td>Sandoz</td>
			<td></td>
			<td>For systemic anticoagulation</td>
		</tr>
		<tr>
			<td>Hydrochloric Acid 36,5 to 38,0%</td>
			<td>Fisher scientific</td>
			<td>A144-500</td>
			<td>Diluted 1:1 for pH correction</td>
		</tr>
		<tr>
			<td>Ketamine</td>
			<td>Bimeda</td>
			<td></td>
			<td>Anesthetic. 100 mg/ml</td>
		</tr>
		<tr>
			<td>LabChart</td>
			<td>ADinstruments</td>
			<td></td>
			<td>Control software for the Powerlab polygraph, allowing off-line analyses. Version 7, with blood pressure and PV loop modules enabled</td>
		</tr>
		<tr>
			<td>Left ventricle pressure balloon</td>
			<td>Radnoti</td>
			<td>170404</td>
			<td>In latex. Size 4.</td>
		</tr>
		<tr>
			<td>Lidocaine HCl 2% solution</td>
			<td>AstraZeneca</td>
			<td></td>
			<td>Antiarrhythmic for the cardioplegic solution</td>
		</tr>
		<tr>
			<td>Magnesium Chloride ACS</td>
			<td>ACP Chemicals</td>
			<td>M-0460</td>
			<td>MgCl2+6H2O &#8805;99.0% Part of the Krebs solution</td>
		</tr>
		<tr>
			<td>Micro pressure sensor</td>
			<td>Radnoti</td>
			<td>159905</td>
			<td>Micro pressure sensor and amplifier connected to the intraventricular balloon</td>
		</tr>
		<tr>
			<td>Pacemaker</td>
			<td>Biotronik</td>
			<td>Reliaty</td>
			<td>Set to generate a pulse each 200 ms for a heart rate of 300 bpm.</td>
		</tr>
		<tr>
			<td>pH bench top meter</td>
			<td>Fisher scientific</td>
			<td>AE150</td>
			<td></td>
		</tr>
		<tr>
			<td>Physiological monitor</td>
			<td>Kent Scientific</td>
			<td>Physiosuite</td>
			<td>For continuous monitoring of rodent temperature and saturation during the procedure</td>
		</tr>
		<tr>
			<td>Plasma-Lyte A</td>
			<td>Baxter</td>
			<td></td>
			<td>Electrolyte solution used as base to prepare cardioplegia</td>
		</tr>
		<tr>
			<td>Potassium Chloride</td>
			<td>Milipore-Sigma</td>
			<td>P4504</td>
			<td>KCl &#8805;99.0% Part of the Krebs solution</td>
		</tr>
		<tr>
			<td>Potassium Chloride 2 meq/ml</td>
			<td>Hospira</td>
			<td></td>
			<td>Part of the cardioplegic solution</td>
		</tr>
		<tr>
			<td>PowerLab 8/30 Polygraph</td>
			<td>ADinstruments</td>
			<td></td>
			<td>Electronic polygraph</td>
		</tr>
		<tr>
			<td>Silk 2-0</td>
			<td>Ethicon</td>
			<td>A305H</td>
			<td>Suture material for Langendorff apparatus</td>
		</tr>
		<tr>
			<td>Silk 5-0</td>
			<td>Ethicon</td>
			<td>A302H</td>
			<td>Suture material for carotid</td>
		</tr>
		<tr>
			<td>Small animal anesthesia workstation</td>
			<td>Hallowell EMC</td>
			<td>000A2770</td>
			<td>Small animal ventilator</td>
		</tr>
		<tr>
			<td>Sodium bicarbonate</td>
			<td>Milipore-Sigma</td>
			<td>S5761</td>
			<td>NaHCO3 &#8805;99,5% Part of the Krebs solution</td>
		</tr>
		<tr>
			<td>Sodium Chloride</td>
			<td>Milipore-Sigma</td>
			<td>S7653</td>
			<td>NaCl &#8805;99.5% Part of the Krebs solution</td>
		</tr>
		<tr>
			<td>Sodium Hydroxide pellets</td>
			<td>ACP chemicals</td>
			<td>S3700</td>
			<td>Diluted to 5N (10 g in 50 ml) for pH correction</td>
		</tr>
		<tr>
			<td>Sodium phosphate monobasic</td>
			<td>Milipore-Sigma</td>
			<td>S0751</td>
			<td>NaH2PO4 &#8805;99.0% Part of the Krebs solution</td>
		</tr>
		<tr>
			<td>Stevens Tenotomy Sciss, Str, Delicate, SH/SH, 4 1/2&#34;</td>
			<td>Skalar</td>
			<td>22-1240</td>
			<td>Small scisors for atria and cava vein opening</td>
		</tr>
		<tr>
			<td>Tissue slicer blades</td>
			<td>Thomas scientific</td>
			<td>6727C18</td>
			<td>Straight carbon steel blades for tissue slicing at the end of the protocol</td>
		</tr>
		<tr>
			<td>Tuberculin safety syringe with needle 25G 5/8&#34;</td>
			<td>CardinalHealth</td>
			<td>8881511235</td>
			<td>For heparin injection</td>
		</tr>
		<tr>
			<td>Veterinary General Surgery Set</td>
			<td>Skalar</td>
			<td>98-1275</td>
			<td>Surgery instruments including disection scisors and mosquito clamps</td>
		</tr>
		<tr>
			<td>Veterinary Micro Set</td>
			<td>Skalar</td>
			<td>98-1311</td>
			<td>Surgery instruments with microscisors used for carotid artery opening</td>
		</tr>
		<tr>
			<td>Working Heart Rat/Guinea Pig/Rabbit system</td>
			<td>Radnoti</td>
			<td>120101BEZ</td>
			<td>Modular working heart system modified for the needs of the protocol. Includes all the necesary tubbing, water jacketed reservoirs and valves, including 2 and 3 way stop cock</td>
		</tr>
		<tr>
			<td>Xylazine</td>
			<td>Bayer</td>
			<td></td>
			<td>Sedative. 20 mg/ml</td>
		</tr>
	</tbody>
</table>

pre-clinical model of cardiac donation after circulatory death

心脏移植需求呈上升趋势;然而,由于缺乏合适的捐赠者,器官的可得性有限。循环死亡后器官捐献 (DCD) 是解决这种有限可用性的解决方案,但由于长期温暖的缺血期和组织损伤的风险,其常规使用在心脏移植中很少见。在本手稿中,我们提供了一个详细的方案,通过持续监测心脏功能,在DCD的背景下密切模仿当前的临床实践,允许评估新的心脏保护策略和干预措施,以减少缺血性再灌注损伤。
在此模型中,DCD协议通过停止通气诱导循环死亡在麻醉的Lewis大鼠中启动。当收缩压降至 30 mmHg 以下时,开始出现温暖的缺血时间。在预先设定的温暖缺血期后,心脏被冲洗与规范的性心液溶液,采购,并安装在兰根多夫前体内心脏灌注系统。在初始再灌注和稳定10分钟后,使用室内压力监测持续评估心脏修复60分钟。通过测量心脏肌钙蛋白 T 来评估心脏损伤,并且通过组织染色量化梗死大小。温暖的缺血时间可以调整和定制,以发展所需的结构和功能损伤量。这个简单的协议允许评估在心痛、初始再灌注和/或前体灌注时引入的不同心内保护调节策略。从该协议获得的发现可以复制在大型模型中,便于临床翻译。

排泄后,血压迅速下降,以可预测的模式(图3)。预计死亡时间小于5分钟。
图 4显示了 WIT 0、10 和 15 分钟之后修复开始时的平均压力/时间曲线。收缩功能将随着时间的推移而改善。短时间的 WIT 将使收缩性恢复正常,并且形态损伤将不可检测(图 5和图 6)。
与心胸结合一?...

Watch this Scientific Journal Video about Pre-clinical Model of Cardiac Donation after Circulatory Death at JoVE.com

Pre-clinical Model of Cardiac Donation after Circulatory Death

该协议显示了一种简单而灵活的方法,用于评估新的调理剂或策略,以提高循环死亡后心脏捐赠的可行性。

循环死亡后心脏捐献的临床前模型

Cardiac transplantation demand is on the rise; nevertheless, organ availability is limited due to a paucity of suitable donors. Organ donation after ...

该协议针对有限的移植器官供应问题，促进对不同心脏保护调节策略的评估，允许使用循环死亡后捐赠的心脏。将动物放在设置为中等的加热垫上。在确认麻醉成年大鼠对手趾捏没有反应后，插入直肠温度探针。将透皮脉冲血氧计传感器连接到后爪，用吸水垫盖住大鼠以保持体温。在颈部做一个三到四厘米的中线皮肤切口，并使用钝尖弯曲剪刀钝解解皮下组织，暴露右胸肌。使用非创伤钳，横向移动肌肉，直到右肌动脉，血管和迷走神经被识别。用剪刀小心地将迷走神经与心肌动脉分开。每公斤肝素注射2000国际单位到右血管中，在针头缩回后向注射部位施加压力，以避免血液泄漏。使用弯曲钳子在胡萝卜动脉周围传递两个 5-0 的丝绸缝合线。将外露缝合牢固地固定在外露动脉的上部，保持近近缝合，将大鼠置于立体显微镜下。然后使用显微外科剪刀在胡萝卜动脉前壁上小心地切口一毫米，并将一个 22 量、一英寸的封闭静脉导管插入主动脉拱门。强烈建议使用这些步骤使用放大和微剖工具。通过张紧近近缝合线以避免出血，可以实现清洁的田地。心脏捐赠是组装外体心肺功能痛器械所必需的。要启动 DCD 协议，首先对动物进行排泄，然后使用蚊子钳夹住气管，开始前一阶段。当峰值收缩压降至30毫米以下的汞或囊肿或心室颤动时，开始计算功能 WIT，以先到者为准。在 WIT 结束时，执行中伸骨切除术，如有必要，使用 Alm 缩回器保持胸部打开。将心脏与肺静脉和其他胸腔结构分离，以完成切除术。立即将心脏淹没在冰冷的 Krebs 解决方案中，快速运输到外体系统。使用2-0丝线，将大道紧贴在兰根多夫仪器上，然后打开塞子。现在完全打开流到管，并开始初始再灌注和稳定时间。旋转心脏，使动脉面对压力传感器，并解剖肺静脉，以扩大左心室心房开口，如有必要。接下来，插入连接到压力传感器的乳胶气球，确保气球完全位于心室内。慢慢地用盐水填充气球，直到最终舒张压达到15毫米汞。将起搏电极插入心脏前脸，而不刺穿冠状动脉血管。观察到自发跳动后，将起搏设置为每分钟 300 次。稳定10分钟后，启动连续的机内压力测量记录，开始修复和评估阶段。一小时后，从兰根多夫仪器上取出心脏，并使用直高碳钢刀片取出阿克里斯。右心室朝下，切割一到两毫米厚的横向心室切片。从第三片组织中切除右心室，并捕捉冻结左心室，进行下游生化分析。将其余部分在 PBS 中新准备的 5%TTC 溶液中，在 37 摄氏度下 10 分钟。第二天早上，将样品用新鲜 PBS 洗涤两次，将样品淹没在新鲜 PBS 中进行成像。可行的组织将显示砖红色的颜色。分流后，血压以可预测的模式迅速下降，预计死亡时间不到五分钟。此处显示了 WIT 零、10 和 15 分钟后修复开始时的平均压力与时间曲线。收缩功能将随着时间的推移而改善，使用短期的WIT将允许收缩恢复正常，形态损伤将不能检测。使用与心痛一起添加的调理剂，在稳定阶段表明，此模型中 15 分钟 WIT 产生的损伤可经心保护剂调节。该技术允许完全控制所有相关变量和药理学和非药理干预测试，并可以在更大的模型中复制，促进临床翻译。

pre-clinical-model-of-cardiac-donation-after-circulatory-death

Research

JoVE Journal

Medicine

Pre-clinical Evaluation of Tyrosine Kinase Inhibitors for Treatment of Acute Leukemia

Receptor tyrosine kinases have been implicated in the development and progression of many cancers, including both leukemia and solid tumors, and are attractive druggable therapeutic targets. Here we describe an efficient four-step strategy for pre-clinical evaluation of tyrosine kinase inhibitors (TKIs) in the treatment of acute leukemia. Initially, western blot analysis is used to confirm target inhibition in cultured leukemia cells. Functional activity is then evaluated using clonogenic assays in methylcellulose or soft agar cultures. Experimental compounds that demonstrate activity in cell culture assays are evaluated in vivo using NOD-SCID-gamma (NSG) mice transplanted orthotopically with human leukemia cell lines. Initial in vivo pharmacodynamic studies evaluate target inhibition in leukemic blasts isolated from the bone marrow. This approach is used to determine the dose and schedule of administration required for effective target inhibition. Subsequent studies evaluate the efficacy of the TKIs in vivo using luciferase expressing leukemia cells, thereby allowing for non-invasive bioluminescent monitoring of leukemia burden and assessment of therapeutic response using an in vivo bioluminescence imaging system. This strategy has been effective for evaluation of TKIs in vitro and in vivo and can be applied for identification of molecularly-targeted agents with therapeutic potential or for direct comparison and prioritization of multiple compounds.

Receptor tyrosine kinases are ectopically expressed in many cancers and have been identified as therapeutic targets in acute leukemia. This manuscript describes an efficient strategy for pre-clinical evaluation of tyrosine kinase inhibitors for the treatment of acute leukemia.

酪氨酸激酶抑制剂的临床前评价急性白血病的治疗

Receptor tyrosine kinases have been implicated in the development and progression of many cancers, including both leukemia and solid tumors, and are ...

科研

医学

Handling of the Cotton Rat in Studies for the Pre-clinical Evaluation of Oncolytic Viruses

Oncolytic viruses are a novel anticancer therapy with the ability to target tumor cells, while leaving healthy cells intact. For this strategy to be successful, recent studies have shown that involvement of the host immune system is essential. Therefore, oncolytic virotherapy should be evaluated within the context of an immunocompetent model. Furthermore, the study of antitumor therapies in tolerized animal models may better recapitulate results seen in clinical trials. Cotton rats, commonly used to study respiratory viruses, are an attractive model to study oncolytic virotherapy as syngeneic models of mammary carcinoma and osteosarcoma are well established. However, there is a lack of published information on the proper handling procedure for these highly excitable rodents. The handling and capture approach outlined minimizes animal stress to facilitate experimentation. This technique hinges upon the ability of the researcher to keep calm during handling and perform procedures in a timely fashion. Finally, we describe how to prepare cotton rat mammary tumor cells for consistent subcutaneous tumor formation, and how to perform intratumoral and intraperitoneal injections. These methods can be applied to a wide range of studies furthering the development of the cotton rat as a relevant pre-clinical model to study antitumor therapy.

Cotton rats are extremely excitable and have a strong flight-or-fight response. A handling method optimized to reduce the stress of the animals is described which will make cotton rats more accessible as a preclinical model.

处理棉鼠的研究为溶瘤病毒的临床前评估

Oncolytic viruses are a novel anticancer therapy with the ability to target tumor cells, while leaving healthy cells intact.  For this strategy to be ...

Pre-clinical Orthotopic Murine Model of Human Prostate Cancer

To study the multifaceted biology of prostate cancer, pre-clinical in vivo models offer a range of options to uncover critical biological information about this disease. The human orthotopic prostate cancer xenograft mouse model provides a useful alternative approach for understanding the specific interactions between genetically and molecularly altered tumor cells, their organ microenvironment, and for evaluation of efficacy of therapeutic regimens. This is a well characterized model designed to study the molecular events of primary tumor development and it recapitulates the early events in the metastatic cascade prior to embolism and entry of tumor cells into the circulation. Thus it allows elucidation of molecular mechanisms underlying the initial phase of metastatic disease. In addition, this model can annotate drug targets of clinical relevance and is a valuable tool to study prostate cancer progression. In this manuscript we describe a detailed procedure to establish a human orthotopic prostate cancer xenograft mouse model.

Prostate cancer is the second most common cause of cancer-related deaths in the United States. An orthotopic cancer model provides a useful approach to understand the biology of prostate cancer and to evaluate the efficacy of therapeutic regimens. This protocol describes detailed steps necessary to establish an orthotopic prostate cancer mouse model.

人前列腺癌的临床前原位小鼠模型

To study the multifaceted biology of prostate cancer, pre-clinical in vivo models offer a range of options to uncover critical biological information ...

Use of a Low-flow Digital Anesthesia System for Mice and Rats

A traditional vaporizer depends on flowing gas and atmospheric pressure for passive anesthetic vaporization. Newly developed direct injection vaporizers utilize a syringe pump to directly administer volatile anesthetics into a gas stream. Unlike a traditional vaporizer, it can be used at very low flow rates, making it ideal for use on mice and rats. 
The equipment's capability to use low flow rates could result in a substantial cost savings due to the reduced need for anesthetic agents, compressed gas, and charcoal scavenging filters1. A lower flow rate means less waste of anesthetic gas and likely reduces the risk of anesthetic exposure to laboratory personnel. Thus, the high levels of precision and safety associated with direct injection vaporizers, along with a reduced need for anesthetic agents, compressed gas, and charcoal filters are beneficial for research requiring small animal anesthesia. 
The goal of this protocol is to demonstrate the use of a syringe-driven direct injection vaporizer as part of a digital, low-flow anesthesia system. The direct injection vaporizer is capable of accurately delivering anesthesia at very low flow rates compared to a traditional vaporizer, making it a promising alternative for controlled gas anesthetic delivery to rodents.

Here, we present a protocol to more safely and efficiently administer anesthetic gas to mice using a digital, low flow anesthesia system utilizing a syringe-driven direct injection vaporizer.

低流量数字麻醉系统的小鼠和大鼠的用途

A traditional vaporizer depends on flowing gas and atmospheric pressure for passive anesthetic vaporization. Newly developed direct injection vaporizers ...

Isometric Contractility Measurement of the Mouse Mesenteric Artery Using Wire Myography

The wire myograph technique is used to assess the contractility of vascular smooth muscles in response to depolarization, GPCR agonists/inhibitors and drugs. It is widely used in many studies on the physiological functions of vascular smooth muscle, the pathogenesis of vascular diseases such as hypertension, and the development of smooth muscle relaxant drugs. The mouse is a widely used model animal with a large pool of disease models and genetically modified strains. We introduced this method to measure the isometric contraction of mouse mesenteric artery in detail. A 1.4-mm segment of mouse mesenteric resistance artery was isolated and mounted on a myograph chamber by passing two steel wires through its lumen. After equilibration and normalization steps, the vessel segment was potentiated by a high-K+ solution twice prior to the contraction assay. As an example of the application of this method in drug development, we measured the relaxant effect of a novel natural substance, neoliensinine, isolated from a Chinese herb, embryos of the lotus seed (Nelumbo nucifera Gaertn.) on mouse mesenteric arteries. The vessel segments mounted on the myograph chamber were stimulated with a high-K+ solution. When the force tension reached a stable sustained phase, cumulative doses of neoliensinine were added to the chamber. We found that neoliensinine had a dose-dependent relaxant effect on smooth muscle contraction, thus suggesting that it bears potential activity against hypertension. In addition, as the vessel segment can survive at least 4 hours after mounting and maintain contractility induced by the high-K+ solution for many times, we suggest that the wire myograph system may be used for the time-consuming process of drug screening.

The wire myograph technique is used to investigate vascular smooth muscle functions and screen new drugs. We report a detailed protocol for measuring the isometric contractility of the mouse mesenteric artery and for screening new relaxants of vascular smooth muscle.

用线 Myography 测定小鼠肠系膜动脉的等轴收缩力

The wire myograph technique is used to assess the contractility of vascular smooth muscles in response to depolarization, GPCR agonists/inhibitors and ...

Implantation of hiPSC-derived Cardiac-muscle Patches after Myocardial Injury in a Guinea Pig Model

Due to the limited regeneration capacity of the heart in adult mammals, myocardial infarction results in an irreversible loss of cardiomyocytes. This loss of relevant amounts of heart muscle mass can lead to the heart failure. Besides heart transplantation, there is no curative treatment option for the end-stage heart failure. In times of organ donor shortage, organ independent treatment modalities are needed. Left-ventricular assist devices are a promising therapy option, however, especially as destination therapy, limited by its side-effects like stroke, infections and bleedings. In recent years, several cardiac repair strategies including stem cell injection, cardiac progenitors or myocardial tissue engineering have been investigated. Recent improvements in cell biology allow for the differentiation of large amounts of cardiomyocytes derived from human induced pluripotent stem cells (iPSC). One of the cardiac repair strategies currently under evaluation is to transplant artificial heart tissue. Engineered heart tissue (EHT) is a three-dimensional in vitro created cardiomyocyte network, with functional properties of native heart tissue. We have created EHT-patches from hiPSC derived cardiomyocytes. Here we present a protocol for the induction of left ventricular myocardial cryoinjury in a guinea pig, followed by implantation of hiPSC derived EHT on the left ventricular wall.

Here we present a protocol for the induction of left ventricular cryoinjury followed by the implantation of a cardiac muscle patch, derived from human iPS-cell cardiomyocytes in a guinea pig model.

几内亚猪模型心肌损伤后 hiPSC-derived 衍生心肌贴片的植入

Due to the limited regeneration capacity of the heart in adult mammals, myocardial infarction results in an irreversible loss of cardiomyocytes. This loss ...

A Pre-Clinical Porcine Model of Orthotopic Heart Transplantation

Fifty-years following the first successful report, cardiac transplantation remains the gold-standard treatment for eligible patients with advanced heart failure. Multiple small-animal models of heart transplantation have been used to study the acute and long-term effects of novel therapies. However, few are tested and demonstrated success in clinical trials. It is of critical importance to evaluate new therapies in a clinically relevant large-animal model for efficient and reliable translation of basic studies&#39;&#160;findings. Here, we describe a pre-clinical large-animal (porcine) model of orthotopic heart transplantation that has been firmly established and previously used to investigate novel cardioprotective strategies. This procedure focuses on acute ischemia-reperfusion injury and is a reliable method to investigate novel interventions which have been tested and validated in smaller experimental models, such as the murine model. We demonstrate its usefulness in assessing cardiac performance during the early post-transplantation period and other potential possibilities enabled by the model.

Here, we describe a pre-clinical large-animal (porcine) model of orthotopic heart transplantation that has been firmly established and utilized to investigate novel cardioprotective strategies.

正交心脏移植的临床前猪模型

Fifty-years following the first successful report, cardiac transplantation remains the gold-standard treatment for eligible patients with advanced heart ...

Invasive Hemodynamic Assessment for the Right Ventricular System and Hypoxia-Induced Pulmonary Arterial Hypertension in Mice

Pulmonary arterial hypertension (PAH) is a chronic and severe cardiopulmonary disorder. Mice are a popular animal model used to mimic this disease. However, the evaluation of right ventricular pressure (RVP) and pulmonary artery pressure (PAP) remains technically challenging in mice. RVP and PAP are more difficult to measure than left ventricular pressure because of the anatomical differences between the left and right heart systems. In this paper, we describe a stable right heart hemodynamic measurement method and its validation using healthy and PAH mice. This method is based on open-chest surgery and mechanical ventilation support. It is a complicated procedure compared to closed chest procedures. While a well-trained surgeon is required for this surgery, the advantage of this procedure is that it can generate both RVP and PAP parameters at the same time, so it is a preferable procedure for the evaluation of PAH models.

Here, we present a protocol to perform an invasive hemodynamic assessment of the right ventricle and pulmonary artery in mice using an open-chest surgery approach.

小鼠右心室系统及缺氧诱发肺动脉高血压的侵入性血液动力学评估

Pulmonary arterial hypertension (PAH) is a chronic and severe cardiopulmonary disorder. Mice are a popular animal model used to mimic this disease. ...

A Pre-clinical Rat Model for the Study of Ischemia-reperfusion Injury in Reconstructive Microsurgery

Ischemia-reperfusion injury is the main cause of flap failure in reconstructive microsurgery. The rat is the preferred preclinical animal model in many areas of biomedical research due to its cost-effectiveness and its translation to humans. This protocol describes a method to create a preclinical free skin flap model in rats with ischemia-reperfusion injury. The described 3 cm x 6 cm rat free skin flap model is easily obtained after the placement of several vascular ligatures and the section of the vascular pedicle. Then, 8 h after the ischemic insult and completion of the microsurgical anastomosis, the free skin flap develops the tissue damage. These ischemia-reperfusion injury-related damages can be studied in this model, making it a suitable model for evaluating therapeutic agents to address this pathophysiological process. Furthermore, two main monitoring techniques are described in the protocol for the assessment of this animal model: transit-time ultrasound technology and laser speckle contrast analysis.

Here, we describe a pre-clinical animal model for studying the pathophysiology of ischemia-reperfusion injury in reconstructive microsurgery. This free skin flap model based on the superficial caudal epigastric vessels in the rat may also allow for the evaluation of different therapies and compounds to counteract ischemia-reperfusion injury-related damage.

重建显微外科缺血再灌注损伤研究的临床前大鼠模型

Ischemia-reperfusion injury is the main cause of flap failure in reconstructive microsurgery. The rat is the preferred preclinical animal model in many ...

Use of an Integrated Low-Flow Anesthetic Vaporizer, Ventilator, and Physiological Monitoring System for Rodents

Low-flow digital vaporizers commonly utilize a syringe pump to directly administer volatile anesthetics into a stream of carrier gas. Per animal welfare recommendations, animals are warmed and monitored during procedures requiring anesthesia. Common anesthesia and physiological monitoring equipment include gas tanks, anesthetic vaporizers and stands, warming controllers and pads, mechanical ventilators, and pulse oximeters. A computer is also necessary for data collection and to run equipment software. In smaller spaces or when performing field work, it can be challenging to configure all this equipment in limited space.
The goal of this protocol is to demonstrate best practices for use of a low-flow digital vaporizer using both compressed oxygen and room air, along with an integrated mechanical ventilator, pulse oximeter, and far infrared warming as an all-inclusive anesthesia and physiological monitoring suite ideal for rodents.

Here, we present a protocol to safely and effectively administer anesthetic gas to mice using a digital, low flow anesthesia system with integrated ventilator and physiological monitoring modules.

使用啮齿动物综合低流量麻醉蒸发器、呼吸机和生理监测系统

Low-flow digital vaporizers commonly utilize a syringe pump to directly administer volatile anesthetics into a stream of carrier gas. Per animal welfare ...