Name: ex vivo porcine experimental model for studying and teaching lung mechanics
Uploaded: 2024-04-19T12:30:00
Description: Watch this Scientific Journal Video about Ex Vivo Porcine Experimental Model for Studying and Teaching Lung Mechanics at JoVE.com

我们感谢所有为构建该 离体 猪肺模型方案做出贡献和支持的同事和专业人士。
这项研究没有资金来源。

该协议已获得我们机构动物研究伦理委员会的批准（协议编号 1610/2021）。
1.麻醉和动物准备
<ol><li>最初，将动物放在秤上并检查体重以调整手术所需的药物和镇静剂。</li>
	<li>肌肉注射氯胺酮 5 mg/kg 和咪达唑仑 0.25 mg/kg。</li>
	<li>用 20 G 静脉导管刺穿边缘耳静脉，静脉注射异丙酚 （5 mg/kg） 进行麻醉诱导。</li>
	<li>静脉注射 3 mL 肝素进入边缘耳静脉，以协助心肺?...

<ol>
	<li>Roberto, C., Carvalho, R., Toufen Jr, C., Franca, S. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Mechanical+Ventilation:+Principles,+graphic+analysis+and+ventilation+modalities.">Mechanical Ventilation: Principles, graphic analysis and ventilation modalities.</a> Jornal Brasileiro de Pneumologia. 33 (2), 54-55 (2007).</li><li>Barbas, C. S. V., 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=Brazilian+recommendations+for+mechanical+ventilation+2013.+Part+I.">Brazilian recommendations for mechanical ventilation 2013. Part I.</a> Revista Brasileira de Terapia Intensiva. 26 (2), 89-121 (2014).</li><li>Walter, J. M., Corbridge, T. C., Singer, B. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Invasive+mechanical+ventilation.">Invasive mechanical ventilation.</a> Southern Medical Journal. 111 (12), 746-753 (2018).</li><li>Faustino, E. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Concepts+and+monitoring+of+pulmonary+mechanics+in+patients+under+ventilatory+support+in+the+intensive+care+unit.">Concepts and monitoring of pulmonary mechanics in patients under ventilatory support in the intensive care unit.</a> Revista Brasileira de Terapia Intensiva. 19 (2), 161-169 (2007).</li><li>Holanda, M. A., Vasconcelos, R. S., Ferreira, J. C., Pinheiro, B. V. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Patient-ventilator+asynchrony.">Patient-ventilator asynchrony.</a> Jornal Brasileiro de Pneumologia. 44 (2), 321-333 (2018).</li><li>Rezoagli, E., Laffey, J. G., Bellani, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Monitoring+lung+injury+severity+and+ventilation+intensity+during+mechanical+ventilation.">Monitoring lung injury severity and ventilation intensity during mechanical ventilation.</a> Seminars in Respiratory and Critical Care Medicine. 43 (3), 346-368 (2022).</li><li>Tallo, F. S. <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+self-perception+of+mechanical+ventilation+knowledge+among+Brazilian+final-year+medical+students,+residents,+and+emergency+physicians.">Evaluation of self-perception of mechanical ventilation knowledge among Brazilian final-year medical students, residents, and emergency physicians.</a> Clinics. 72 (2), 65-70 (2017).</li><li>Schroedl, C. 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=Impact+of+simulation-based+mastery+learning+on+resident+skill+managing+mechanical+ventilators.">Impact of simulation-based mastery learning on resident skill managing mechanical ventilators.</a> American Thoracic Society Scholar. 2 (1), 34-48 (2021).</li><li>Wilcox, S. 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=Academic+emergency+medicine+physicians'+knowledge+of+mechanical+ventilation.">Academic emergency medicine physicians' knowledge of mechanical ventilation.</a> The Western Journal of Emergency Medicine. 17 (3), 271-279 (2016).</li><li>Cox, C. 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=Effectiveness+of+medical+resident+education+in+mechanical+ventilation.">Effectiveness of medical resident education in mechanical ventilation.</a> American Journal of Respiratory and Critical Care Medicine. 167 (1), 32-38 (2003).</li><li>Keegan, R., Henderson, T., Brown, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Use+of+the+virtual+ventilator,+a+screen-based+computer+simulation,+to+teach+the+principles+of+mechanical+ventilation.">Use of the virtual ventilator, a screen-based computer simulation, to teach the principles of mechanical ventilation.</a> Journal of Veterinary Medical Education. 36 (4), 436-443 (2009).</li><li>Spadaro, S., 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=Simulation+training+for+residents+focused+on+mechanical+ventilation:+A+randomized+trial+using+mannequin-based+versus+computer-based+simulation.">Simulation training for residents focused on mechanical ventilation: A randomized trial using mannequin-based versus computer-based simulation.</a> Simulation in Healthcare. 12 (6), 349-355 (2017).</li><li>Chase, J. G., Yuta, T., Mulligan, K. J., Shaw, G. M., Horn, B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+novel+mechanical+lung+model+of+pulmonary+diseases+to+assist+with+teaching+and+training.">A novel mechanical lung model of pulmonary diseases to assist with teaching and training.</a> BMC Pulmonary Medicine. 6 (21), 1-11 (2006).</li><li>Kuebler, W. M., Mertens, M., Pries, 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=A+two-component+simulation+model+to+teach+respiratory+mechanics.">A two-component simulation model to teach respiratory mechanics.</a> Advances in Physiology Education. 31 (2), 218-222 (2007).</li><li>Heili-Frades, S., Peces-Barba, G., Rodr&#237;guez-Nieto, 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=Design+of+a+lung+simulator+for+learning+lung+mechanics+in+mechanical+ventilation.">Design of a lung simulator for learning lung mechanics in mechanical ventilation.</a> Archivos de Bronconeumolog&#237;a. 43 (12), 674-679 (2007).</li><li>Ngo, C., Dahlmanns, S., Vollmer, T., Misgeld, B., Leonhardt, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=An+object-oriented+computational+model+to+study+cardiopulmonary+hemodynamic+interactions+in+humans.">An object-oriented computational model to study cardiopulmonary hemodynamic interactions in humans.</a> Computer Methods and Programs in Biomedicine. 159, 167-183 (2018).</li><li>Lazzari, C. D., Genuini, I., Pisanelli, D. M., D'Ambrosi, A., Fedele, F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Interactive+simulator+for+e-Learning+environments:+a+teaching+software+for+health+care+professionals.">Interactive simulator for e-Learning environments: a teaching software for health care professionals.</a> Biomedical Engineering Online. 13 (172), 1-18 (2014).</li><li>Perinel, S., 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=Development+of+an+ex+vivo+human-porcine+respiratory+model+for+preclinical+studies.">Development of an ex vivo human-porcine respiratory model for preclinical studies.</a> Scientific Reports. 7, 1-6 (2017).</li><li>Aboelnazar, N. S., 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=Negative+pressure+ventilation+decreases+inflammation+and+lung+edema+during+normothermic+ex-vivo+lung+perfusion.">Negative pressure ventilation decreases inflammation and lung edema during normothermic ex-vivo lung perfusion.</a> The Journal of Heart and Lung Transplantation. 37 (4), 520-530 (2018).</li><li>Sattari, S., 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=Introducing+a+custom-designed+volume-pressure+machine+for+novel+measurements+of+whole+lung+organ+viscoelasticity+and+direct+comparisons+between+positive-+and+negative-pressure+ventilation.">Introducing a custom-designed volume-pressure machine for novel measurements of whole lung organ viscoelasticity and direct comparisons between positive- and negative-pressure ventilation.</a> Frontiers in Bioengineering and Biotechnology. 8, 1-12 (2020).</li><li>Sattari, S., 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=Positive-+and+negative-pressure+ventilation+characterized+by+local+and+global+pulmonary+mechanics.">Positive- and negative-pressure ventilation characterized by local and global pulmonary mechanics.</a> American Journal of Respiratory and Critical Care Medicine. 207 (5), 577-586 (2023).</li><li>Montigaud, 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=Development+of+an+ex+vivo+preclinical+respiratory+model+of+idiopathic+pulmonary+fibrosis+for+aerosol+regional+studies.">Development of an ex vivo preclinical respiratory model of idiopathic pulmonary fibrosis for aerosol regional studies.</a> Scientific Reports. 9 (1), 17949 (2019).</li><li>Montigaud, 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=Aerosol+delivery+during+invasive+mechanical+ventilation:+development+of+a+preclinical+ex+vivo+respiratory+model+for+aerosol+regional+deposition.">Aerosol delivery during invasive mechanical ventilation: development of a preclinical ex vivo respiratory model for aerosol regional deposition.</a> Scientific Reports. 9 (1), 17930 (2019).</li><li>Montigaud, 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=Development+of+an+ex+vivo+respiratory+pediatric+model+of+bronchopulmonary+dysplasia+for+aerosol+deposition+studies.">Development of an ex vivo respiratory pediatric model of bronchopulmonary dysplasia for aerosol deposition studies.</a> Scientific Reports. 9 (1), 5720 (2019).</li><li>Buchko, M. 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=A+low-cost+perfusate+alternative+for+ex+vivo.+lung+perfusion.">A low-cost perfusate alternative for ex vivo. lung perfusion.</a> transplantation proceedings. 52 (10), 2941-2946 (2020).</li><li>Kondo, N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Development+of+an+effective+method+utilizing+fibrin+glue+to+repair+pleural+defects+in+an+ex-vivo+pig+model.">Development of an effective method utilizing fibrin glue to repair pleural defects in an ex-vivo pig model.</a> Journal of Cardiothoracic Surgery. 15 (1), 110 (2020).</li><li>Gasek, 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=Development+of+alginate+and+gelatin-based+pleural+and+tracheal+sealants.">Development of alginate and gelatin-based pleural and tracheal sealants.</a> Acta Biomaterialia. 131, 222-235 (2021).</li><li>Li, X., 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=Effects+of+individualized+positive+end-expiratory+pressure+combined+with+recruitment+maneuver+on+intraoperative+ventilation+during+abdominal+surgery:+a+systematic+review+and+network+meta-analysis+of+randomized+controlled+trials.">Effects of individualized positive end-expiratory pressure combined with recruitment maneuver on intraoperative ventilation during abdominal surgery: a systematic review and network meta-analysis of randomized controlled trials.</a> Journal of Anesthesia. 36 (2), 303-315 (2022).</li><li>Hu, M. C., Yang, Y. L., Chen, T. T., Lee, C. I., Tam, K. W. T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Recruitment+maneuvers+to+reduce+pulmonary+atelectasis+after+cardiac+surgery:+A+meta-analysis+of+randomized+trials.">Recruitment maneuvers to reduce pulmonary atelectasis after cardiac surgery: A meta-analysis of randomized trials.</a> The Journal of Thoracic and Cardiovascular Surgery. 164 (1), 171-181 (2020).</li><li>Hu, M. 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=Recruitment+maneuvers+in+patients+undergoing+thoracic+surgery:+a+meta-analysis.">Recruitment maneuvers in patients undergoing thoracic surgery: a meta-analysis.</a> General Thoracic and Cardiovascular Surgery. 69 (12), 1553-1559 (2021).</li><li>Zeng, C., Lagier, D., Lee, J. W., Melo, M. F. V. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Perioperative+pulmonary+atelectasis:+Part+I.+Biology+and+mechanisms.">Perioperative pulmonary atelectasis: Part I. Biology and mechanisms.</a> Anesthesiology. 136 (1), 181-205 (2022).</li><li>Niman, 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=Lung+recruitment+after+cardiac+arrest+during+procurement+of+atelectatic+donor+lungs+is+a+protective+measure+in+lung+transplantation.">Lung recruitment after cardiac arrest during procurement of atelectatic donor lungs is a protective measure in lung transplantation.</a> Journal of Thoracic Disease. 14 (8), 2802-2811 (2022).</li><li>Calvo, R. 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=Comparison+of+the+efficacy+of+two+alveolar+recruitment+maneuvers+in+improving+the+lung+mechanics+and+the+degree+of+atelectasis+in+anesthetized+healthy+sheep.">Comparison of the efficacy of two alveolar recruitment maneuvers in improving the lung mechanics and the degree of atelectasis in anesthetized healthy sheep.</a> Research in Veterinary Science. 150 (5), 164-169 (2022).</li><li>Pensier, 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=Effect+of+lung+recruitment+maneuver+on+oxygenation,+physiological+parameters+and+mortality+in+acute+respiratory+distress+syndrome+patients:+a+systematic+review+and+meta-analysis.">Effect of lung recruitment maneuver on oxygenation, physiological parameters and mortality in acute respiratory distress syndrome patients: a systematic review and meta-analysis.</a> Intensive Care Medicine. 45 (12), 1691-1702 (2019).</li><li>Mariano, C. A., Sattari, S., Quiros, K. A. M., Nelson, T. M., Eskandari, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Examining+lung+mechanical+strains+as+influenced+by+breathing+volumes+and+rates+using+experimental+digital+image+correlation.">Examining lung mechanical strains as influenced by breathing volumes and rates using experimental digital image correlation.</a> Respiratory Research. 23 (1), 92 (2022).</li></ol>

所描述的方案可用于在正压MV下生产 离体 猪肺模型。它可用于研究和教授肺力学，在募集过程中通过肺部的视觉反馈以及分析投影在设备屏幕上的曲线和值。为了达到这一结果，需要进行试点研究，以了解肺在肋骨外的行为，并确定适应的必要性。
我们发现关键点是在连接机械呼吸机时在胸膜中形成气泡、瘘管和病变，以及吸入和呼气电视之间的差异以及体积曲线的?...

机械通气 （MV） 广泛用于重症监护病房 （ICU） 和外科中心。其监测对于帮助识别不同步和预防所有患者的损伤至关重要，尤其是当患者有严重的肺损伤时 1,2,3,4,5,6。监测呼吸力学还有助于临床了解疾病进展和治疗应用，例如使用呼气末正压通气 （PEEP） 或肺泡复张操作 （ARM）。然而，使用这些技术需要熟练了解曲线和基本的肺力学 3,4。
学生、住院医师和医疗专业人员对 MV 管理感到不安全，从打开呼吸机和初始调整到监测平台和驾驶压力，这种不安全感与缺乏知识和足够的先前培训有关 7,8,9,10。我们观察到，参与模拟并使用肺模型的专业人员报告了更高的信心、对参数的理解以及对肺力学组成部分的理解 8,11,12。
用于研究和训练具有测试肺、波纹管和活塞的MV的模型可以模拟不同的压力和体积，以及不同的肺力学条件13,14,15。计算和软件模型还通过生成可用于向卫生专业人员教授 MV11 原理的模拟来促进心肺相互作用的研究16,17。
虽然计算模型在表示肺滞后16 方面可能存在困难，但具有测试肺和波纹管13、14、15的模型可以产生类似于生理曲线的压力-容积曲线并显示肺动力学。作为一个优点， 离体 猪肺呈现出与人类相似的解剖结构18，还产生MV曲线，肺滞后，并在肺力学分析期间提供亚克力盒内肺的视觉反馈。可视化模型很重要，可以帮助理解难以想象的组件和概念。因此， 离体 肺模型代表了一种实用的教学方式。
对离体猪肺的研究，例如在正负压下对MV的研究19,20,21，气溶胶分布分析22,23，儿科模拟24和肺灌注25可以提高对MV的了解。最近分析正压和负压模型的研究表明，与负压相比，正压通气可导致突然募集，局部变形更大、膨胀更大、滞后曲线差异和可能的组织损伤 19,20,21。然而，正压模型是必要的，因为患者在 MV压力 19、20、21 期间处于正压之下。用于临床前研究的肺模型的开发为新的研究和应用提供了可能性，包括 MV 教学和培训。
在这里，我们提出了一个用于研究和训练目的 的离体 猪肺模型。我们的主要目的是描述在正压MV下生成这种 离体 猪肺模型的步骤。将来可以用它来研究和教授肺力学。

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>0.9% Saline solution</td>
			<td></td>
			<td></td>
			<td>2500ml</td>
		</tr>
		<tr>
			<td>Anesthesia machine - Primus</td>
			<td>Drager</td>
			<td>REF 8603800-18</td>
			<td>Anesthesia work station used in the procedure</td>
		</tr>
		<tr>
			<td>Aspirator</td>
			<td></td>
			<td></td>
			<td>For blood aspiration from thorax</td>
		</tr>
		<tr>
			<td>Bedside Monitor - Life Scope</td>
			<td>Nihon Kohden</td>
			<td>BSM-7363</td>
			<td>Multiparameter monitor used during the procedure</td>
		</tr>
		<tr>
			<td>Bonney Tissue Forceps</td>
			<td></td>
			<td></td>
			<td>Any tissue forceps is suitable</td>
		</tr>
		<tr>
			<td>Disposable scalper, #23</td>
			<td></td>
			<td></td>
			<td>Any scalper is suitable</td>
		</tr>
		<tr>
			<td>Disposable syringe needles, 18G x 1 1/2&#34;, 23G x 1&#34;</td>
			<td>BD</td>
			<td>302814</td>
			<td>Widely available</td>
		</tr>
		<tr>
			<td>Disposable syringes, 10ml</td>
			<td></td>
			<td></td>
			<td>Widely available</td>
		</tr>
		<tr>
			<td>Electrosurgical unit - SS-501</td>
			<td>WEM</td>
			<td></td>
			<td>For cutting and coagulation during thorax incision</td>
		</tr>
		<tr>
			<td>Fentanyl</td>
			<td></td>
			<td></td>
			<td>10 mcg/kg bolus + 10 mcg/kg/hour continuous infusion</td>
		</tr>
		<tr>
			<td>Finochietto retractor</td>
			<td></td>
			<td></td>
			<td>Any finochietto retractor is suitable</td>
		</tr>
		<tr>
			<td>heparin</td>
			<td></td>
			<td></td>
			<td>3ml</td>
		</tr>
		<tr>
			<td>Infusion set</td>
			<td></td>
			<td></td>
			<td>Any infusion set is suitable</td>
		</tr>
		<tr>
			<td>Isoflurane</td>
			<td></td>
			<td></td>
			<td>1.5%</td>
		</tr>
		<tr>
			<td>Kelly Forceps Curved</td>
			<td></td>
			<td></td>
			<td>Any kelly forceps is suitable</td>
		</tr>
		<tr>
			<td>Ketamine</td>
			<td></td>
			<td></td>
			<td>5mg/kg</td>
		</tr>
		<tr>
			<td>Lactated Ringer solution</td>
			<td></td>
			<td></td>
			<td>500ml</td>
		</tr>
		<tr>
			<td>Mechanical ventilator - Servo I</td>
			<td>Maquet</td>
			<td>REF 6449701</td>
			<td>Mechanical ventilator used in the procedure</td>
		</tr>
		<tr>
			<td>Metzenbaum Scissor (Straight and curved)</td>
			<td></td>
			<td></td>
			<td>Any metzenbaum scissor is suitable</td>
		</tr>
		<tr>
			<td>Midazolam</td>
			<td></td>
			<td></td>
			<td>0.25mg/kg</td>
		</tr>
		<tr>
			<td>Orotracheal intubation cannula, #6.5</td>
			<td>Rusch</td>
			<td>112282</td>
			<td>Widely available</td>
		</tr>
		<tr>
			<td>Plexiglass</td>
			<td></td>
			<td></td>
			<td>Custom made plexiglass box: 30x45x60cm</td>
		</tr>
		<tr>
			<td>Polyester suture, 2-0</td>
			<td></td>
			<td></td>
			<td>Widely available</td>
		</tr>
		<tr>
			<td>Potassium choride</td>
			<td></td>
			<td></td>
			<td>10 ml, 19.1% potassium chloride.</td>
		</tr>
		<tr>
			<td>propofol</td>
			<td></td>
			<td></td>
			<td>5mg/kg</td>
		</tr>
		<tr>
			<td>Three way stopcock</td>
			<td></td>
			<td></td>
			<td>Widely available</td>
		</tr>
		<tr>
			<td>Venous catheter, G20 x 1&#34;</td>
			<td>BD</td>
			<td>38183314</td>
			<td>Widely available</td>
		</tr>
	</tbody>
</table>

ex vivo porcine experimental model for studying and teaching lung mechanics

机械通气被广泛使用，需要特定的知识来理解和管理。由于培训和教学方法不足，该领域的卫生专业人员可能会感到不安全和缺乏知识。因此，本文的目的是概述生成离 体 猪肺模型所涉及的步骤，以供将来使用，以研究和教授肺力学。为了生成模型，按照动物研究伦理委员会的指导方针，小心翼翼地从胸部取出五个猪肺，并通过气管插管连接到机械呼吸机。然后对这些肺进行肺泡复张操作。在此过程中记录了呼吸力学参数，并使用摄像机获取肺部视频。这个过程连续重复了五天。不使用时，肺保持冷藏。该模型每天在肺泡复张操作后显示出不同的肺力学;不受日子的影响，只受机动的影响。因此，我们得出结论， 离体 肺模型可以更好地了解肺力学及其影响，甚至可以通过过程各个阶段的视觉反馈来更好地理解肺泡复张操作。

我们使用了五头体重在23.4-26.9公斤之间的母猪，并按照所述方案进行心肺提取和肺力学分析。我们的目的是，该模型通过分析直接从机械呼吸机屏幕收集的峰值压力、平台压、阻力、驱动压力和动态顺应性变量，可用于肺力学研究。模型流程图如 图1所示。
连续五天对肺部进行分析，重复方案第 7.2、8.1、8.2、9.1、9.2 和 9.3 项中描述的整个过程。我们试?...

Watch this Scientific Journal Video about Ex Vivo Porcine Experimental Model for Studying and Teaching Lung Mechanics at JoVE.com

Ex Vivo Porcine Experimental Model for Studying and Teaching Lung Mechanics

我们提出了一个 离体 猪肺模型，用于演示肺力学和肺泡复张操作，用于教学目的。肺可以使用超过一天（最多五天），肺力学变量的变化很小。

离体 猪肺力学研究与教学的实验模型

Mechanical ventilation is widely used and requires specific knowledge for understanding and management. Health professionals in this field may feel ...

机械通气广泛用于呼吸衰竭，部分或完全替代自主通气。其管理需要先验知识和专业知识。然而，一些研究表明，专业人士对其管理感到不安全。任何索赔、缺乏培训或先验知识。实验模型旨在促进机械通气的概念和具有视觉反馈的肺力学可视化。最初获得动物体重以调整手术所需的药物和镇静剂。肌内注射氯胺酮 5 毫克/公斤，咪达唑仑点每公斤 25 毫克。然后用 20 G 静脉导管刺穿边缘耳静脉，静脉注射异丙酚，每公斤 5 毫克用于麻醉诱导。静脉注射 3 毫升肝素至 8 次心肺阻滞提取和灌注。麻醉后，用 6.5 毫米插管进行口气管插管。气管插管必须牢固固定，以防止在手术过程中移位。制备后，通过套管将NMO连接到机械通气，并用1.5%异氟的50%吸入氧部分维持NMO麻醉。和芬太尼，每公斤推注10微克，加上每小时每公斤10微克的连续输注。镇静深度的评估是基于血流动力学参数的监测和气体分析仪的使用进行的。将机械呼吸机调整为潮气量为每公斤 8 毫升的容量控制型号。在机械呼吸机屏幕上选择通气模式和其他设置。必须调整呼吸频率，以维持呼气末 CO2 为 35 至 45 毫米汞柱。做一个足够大的胸骨切口以进入胸腔，在胸骨的 xifoide 突上方 2 厘米至胸骨的 xifoide 突下方 2 厘米处，并定位肋骨牵开器，扩大手术过程中的视野。用手术刀水平切开气管切口。切口必须足够大，以引入新的气管插管，从而移除口腔气管插管。给新引入的气管插管的袖带充气。将新的气管插管直接连接到气管上。气管插管没有缝合，只是绑扎，以避免在肺部放置在通气箱中时渗漏和移动。用手术刀解剖组织以从胸部取出心肺阻滞。最后，将异氟烷浓度提高到5%，并施用10毫升氯化钾。组织解剖后，在吸气结束时用适当的卡利镊子夹住口气管插管，保持肺充气。断开机械呼吸机。切开主动脉，将抽吸器放置在胸腔内，以去除外渗的血液，并保持胸腔的可见性。应小心松解下肺韧带，以避免肺部撕裂伤。夹住口气管插管，从胸腔中取出心肺阻滞，并将其放在托盘上。用大口径单腔导管插管肺动脉，并将其连接到输液装置，连续施用 2000 毫升代码 9% 盐水溶液，直到清澈的液体从主动脉流出。生理盐水溶液应以正常速率施用。避免挤压静脉输液袋。清除血流后，缝合主动脉并再给予一百毫升盐水溶液。生理盐水留在肺内，直到实验结束。准备好肺后，将它们垂直放置在亚克力盒内，并将气管插管连接到机械呼吸机。确保气管插管牢固地固定在气管中。使用以下参数将机械呼吸机调整为容量控制模式。Tau 体积，每公斤 6 毫升。窥视，五厘米的水。吸入氧量，21%呼吸频率，15。吸气暂停时间，10%在机械呼吸机屏幕上选择设置。要开始募集，将 PEEP 从 5 厘米增加到 6 厘米的水，然后逐步增加 2 厘米的水，直到达到 14 厘米的水。使用机械呼吸机上的屏幕按钮增加 PEEP。每个 PEEP 值保持 10 分钟，同时记录肺力学。达到 14 厘米水后，逐步减少 PEEP，减少 2 厘米水，直到达到 6 厘米水，然后将其减少到 5 厘米水。在这种下降过程中，PEEP 值保持五分钟，同时记录肺力学。在复张阶段结束时，在吸气过程中用夹子轻轻夹住气管插管，保持肺部充气。打开亚克力盒。从亚克力盒中取出肺，小心地将它们放入玻璃容器中。将肺放入玻璃容器后，确保夹紧，并倒入 500 毫升 9% 盐水溶液。将肺存放在冰箱中，在2至8摄氏度的温度下，在塑料包装的玻璃容器中存放24小时。重复机械通气过程，并连续五天进行卵巢复张操作。每次完成该过程后，将肺放入玻璃容器中并将其存放在冰箱中。我们连续五天分析肺部，重复流程图中描述的整个过程。我们能够展示肺变量在招募前后的行为，并确定离体肺模型在研究期间的耐久性。我们观察到招募操作前后所有变量之间存在显着差异。操作后峰值压力、平台压和驱动压力降低，而动态顺应性增加，表明肺泡塌陷的开放和肺面积的增加。招募后气道阻力也增加。我们表明，该模型通过肺泡复张操作有效地展示了肺力学的视觉变化，以及它对肺力学研究和教学的有效性。此外，我们表明该模型可以至少连续使用五天。在试点研究中，我们从 5 厘米水的 PEEP 开始，然后以 5 厘米的水增量增加到 25 厘米。然而，峰值和平台压力分别达到大于 40 和 30 厘米的水的值，并形成瘘管。因此，我们选择以两厘米的增量逐渐增加，以更好地分析压力随时间的变化，并了解离体测井模型中的PEEP限值。与死亡率相比，持续充气或增量充气之间没有区别，但除了是最常用的增量充气之外，还可以促进肺力学的逐步分析。已经有一些研究使用具有正压和负压的 XV over C 模型，并采取了不同的举措，例如开发用于临床前研究的类似模型、气溶胶分布的验证以及儿科模拟的建立。尽管目标不同，但这些研究为我们的新研究开辟了可能性，有助于我们的学习模型的应用。尽管研究表明，在XV容积模型中使用正压通气可导致突然募集，其局部变形比负压通气更大。有必要创建正压模型，因为我们的患者在机械通气期间通常会屈服于正压，因为我们首先拥有任何动物解剖学知识的局限性，因此可以正确移除腿部。其次，该模型的评估时间不超过五天。第三，这种模式，非常适合通风教学。最后，为了将其结果转化为所有人，重要的是要考虑动物模型的局限性。X 体内肺模型是可行且可重复的，它可以提交到具有肺力学变量可视化的募集操作中。该模型提供了机械通气下肺部的新视图，通过视觉反馈促进了这些概念的教学。

Research

Without Section

JoVE Journal

Ex Vivo Porcine Experimental Model for Studying and Teaching Lung Mechanics

Medicine

Steps for the Autologous Ex vivo Perfused Porcine Liver-kidney Experiment

Steps for the Autologous Ex vivo Perfused Porcine Liver-kidney Experiment

The use of ex vivo perfused models can mimic the physiological conditions of the liver for short periods, but to maintain normal homeostasis for an ...

科研

医学

Procedure for Human Saphenous Veins Ex Vivo Perfusion and External Reinforcement

Procedure for Human Saphenous Veins Ex Vivo Perfusion and External Reinforcement

步骤人类隐静脉<em&gt;前体内</em&gt;灌注和外部强化

The mainstay of contemporary therapies for extensive occlusive arterial disease is venous bypass graft. However, its durability is threatened by intimal ...

Method of Isolated Ex Vivo Lung Perfusion in a Rat Model: Lessons Learned from Developing a Rat EVLP Program

Method of Isolated Ex Vivo Lung Perfusion in a Rat Model: Lessons Learned from Developing a Rat EVLP Program

的隔离方法<em&gt;离体</em&gt;肺灌注的大鼠模型：教训制定鼠EVLP课程中学

The number of acceptable donor lungs available for lung transplantation is severely limited due to poor quality. Ex-Vivo Lung Perfusion (EVLP) has allowed ...

An Ex vivo Model to Study Hormone Action in the Human Breast

An Ex vivo Model to Study Hormone Action in the Human Breast

一个<em&gt;体外</em&gt;模型在乳腺癌研究激素的作用

The study of hormone action in the human breast has been hampered by lack of adequate model systems. Upon in vitro culture, primary mammary epithelial ...

Ex vivo Live Imaging of Lung Metastasis and Their Microenvironment

Ex vivo Live Imaging of Lung Metastasis and Their Microenvironment

体外肺转移及微环境的实时成像

Metastasis is a major cause for cancer-related morbidity and mortality. Metastasis is a multistep process and due to its complexity, the exact cellular ...

A Small Animal Model of Ex Vivo Normothermic Liver Perfusion

A Small Animal Model of Ex Vivo Normothermic Liver Perfusion

体外常温肝灌注的小动物模型

There is a significant shortage of liver allografts available for transplantation, and in response the donor criteria have been expanded. As a result, ...

Impact of Intracardiac Neurons on Cardiac Electrophysiology and Arrhythmogenesis in an Ex Vivo Langendorff System

Impact of Intracardiac Neurons on Cardiac Electrophysiology and Arrhythmogenesis in an Ex Vivo Langendorff System

心内神经元对体外 Langendorff 系统心脏电生理和心脏交感神经的影响

Since its invention in the late 19th century, the Langendorff ex vivo heart perfusion system continues to be a relevant tool for studying a broad spectrum ...

Ex Vivo Corneal Organ Culture Model for Wound Healing Studies

创面愈合研究的前活体角膜器官培养模型

The cornea has been used extensively as a model system to study wound healing. The ability to generate and utilize primary mammalian cells in two ...

An Ex Vivo Tissue Culture Model for Fibrovascular Complications in Proliferative Diabetic Retinopathy

增殖性糖尿病视网膜病变纤维血管并发症的体外组织培养模型

Diabetic retinopathy (DR) is the most common microvascular complication of diabetes and one of the leading causes of blindness in working-age adults. No ...

Manufacture of a Multi-Purpose Low-Cost Animal Bench-Model for Teaching Tracheostomy

一种用于气管造口术教学的多功能低成本动物模型的制作

Tracheostomy is one of the most frequent procedures, performed through various techniques in the intensive care unit and emergency situations. Despite ...

离体 猪肺力学研究与教学的实验模型

离体猪肺力学研究与教学的实验模型