Name: a model of long-term ventricular fibrillation in isolated rat hearts
Uploaded: 2023-02-17T14:15:00
Description: Watch this Scientific Journal Video about A Model of Long-Term Ventricular Fibrillation in Isolated Rat Hearts at JoVE.com

Este trabalho foi realizado com o apoio da Cirurgia Cardiovascular, First Medical Center, Chinese PLA General Hospital e do Laboratory Animal Center, Chinese PLA General Hospital.

Todos os procedimentos e protocolos experimentais utilizados nesta investigação foram revisados e aprovados pelo Comitê de Cuidados e Uso de Animais do Hospital Geral de PLA.
1. Preparação do aparelho de Langendorff
<ol><li>Prepare o tampão Krebs-Henseleit (K-H). Para preparar o tampão K-H, adicione o seguinte à água destilada: NaCl 118,0 mM, KCl 4,7 mM, MgSO 4 1,2 mM, NaH 2 PO4 1,2 mM, CaCl21,8 mM, NaHCO 3 25,0 mM, glicos...

<ol>
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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=Fifteen-year+experience+with+minimally+invasive+approach+for+reoperations+involving+the+mitral+valve.">Fifteen-year experience with minimally invasive approach for reoperations involving the mitral valve.</a> The Journal of Thoracic and Cardiovascular Surgery. 143 (5), 1062-1068 (2012).</li><li>Cox, J. 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=The+safety+of+induced+ventricular+fibrillation+during+cardiopulmonary+bypass+in+nonhypertrophied+hearts.">The safety of induced ventricular fibrillation during cardiopulmonary bypass in nonhypertrophied hearts.</a> The Journal of Thoracic and Cardiovascular Surgery. 74 (3), 423-432 (1977).</li><li>Schraut, W., Lamberti, J. J., Kampman, K., Glagov, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ventricular+fibrillation+during+cardiopulmonary+bypass:+Long-term+effects+on+myocardial+morphology+and+function.">Ventricular fibrillation during cardiopulmonary bypass: Long-term effects on myocardial morphology and function.</a> The Annals of Thoracic Surgery. 27 (3), 230-234 (1979).</li><li>Li, 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=Pravastatin+attenuates+cardiac+dysfunction+induced+by+lysophosphatidylcholine+in+isolated+rat+hearts.">Pravastatin attenuates cardiac dysfunction induced by lysophosphatidylcholine in isolated rat hearts.</a> European Journal of Pharmacology. 640 (1-3), 139-142 (2010).</li><li>Lang, 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=CXCL10/IP-10+neutralization+can+ameliorate+lipopolysaccharide-induced+acute+respiratory+distress+syndrome+in+rats.">CXCL10/IP-10 neutralization can ameliorate lipopolysaccharide-induced acute respiratory distress syndrome in rats.</a> PLoS One. 12 (1), e0169100 (2017).</li><li>Lubbe, W. F., Bricknell, O. L., Marzagao, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ventricular+fibrillation+threshold+and+vulnerable+period+in+the+isolated+perfused+rat+heart.">Ventricular fibrillation threshold and vulnerable period in the isolated perfused rat heart.</a> Cardiovascular Research. 9 (5), 613-620 (1975).</li><li>Hottentrott, C. E., Towers, B., Kurkji, H. J., Maloney, J. V., Buckberg, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+hazard+of+ventricular+fibrillation+in+hypertrophied+ventricles+during+cardiopulmonary+bypass.">The hazard of ventricular fibrillation in hypertrophied ventricles during cardiopulmonary bypass.</a> The Journal of Thoracic and Cardiovascular Surgery. 66 (5), 742-753 (1973).</li><li>Hottenrott, C., Maloney, J. V., Buckberg, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Studies+of+the+effects+of+ventricular+fibrillation+on+the+adequacy+of+regional+myocardial+flow.+I.+Electrical+vs.+spontaneous+fibrillation.">Studies of the effects of ventricular fibrillation on the adequacy of regional myocardial flow. I. Electrical vs. spontaneous fibrillation.</a> The Journal of Thoracic and Cardiovascular Surgery. 68 (4), 615-625 (1974).</li><li>Buckberg, G. 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=Studies+of+the+effects+of+hypothermia+on+regional+myocardial+blood+flow+and+metabolism+during+cardiopulmonary+bypass.+I.+The+adequately+perfused+beating,+fibrillating,+and+arrested+heart.">Studies of the effects of hypothermia on regional myocardial blood flow and metabolism during cardiopulmonary bypass. I. The adequately perfused beating, fibrillating, and arrested heart.</a> The Journal of Thoracic and Cardiovascular Surgery. 73 (1), 87-94 (1977).</li><li>Gazmuri, R. J., Berkowitz, M., Cajigas, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Myocardial+effects+of+ventricular+fibrillation+in+the+isolated+rat+heart.">Myocardial effects of ventricular fibrillation in the isolated rat heart.</a> Critical Care Medicine. 27 (8), 1542-1550 (1999).</li><li>Clasen, 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+modified+approach+for+programmed+electrical+stimulation+in+mice:+Inducibility+of+ventricular+arrhythmias.">A modified approach for programmed electrical stimulation in mice: Inducibility of ventricular arrhythmias.</a> PLoS One. 13 (8), e0201910 (2018).</li><li>Diaz-Maue, 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=Advanced+cardiac+rhythm+management+by+applying+optogenetic+multi-site+photostimulation+in+murine+hearts.">Advanced cardiac rhythm management by applying optogenetic multi-site photostimulation in murine hearts.</a> Journal of Visualized Experiments. (174), e62335 (2021).</li><li>Jungen, 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=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.</a> Journal of Visualized Experiments. 135, e57617 (2018).</li><li>Koretsune, Y., Marban, E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cell+calcium+in+the+pathophysiology+of+ventricular+fibrillation+and+in+the+pathogenesis+of+postarrhythmic+contractile+dysfunction.">Cell calcium in the pathophysiology of ventricular fibrillation and in the pathogenesis of postarrhythmic contractile dysfunction.</a> Circulation. 80 (2), 369-379 (1989).</li><li>Brazier, J. R., Cooper, N., McConnell, D. H., Buckberg, G. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Studies+of+the+effects+of+hypothermia+on+regional+myocardial+blood+flow+and+metabolism+during+cardiopulmonary+bypass.+III.+Effects+of+temperature,+time,+and+perfusion+pressure+in+fibrillating+hearts.">Studies of the effects of hypothermia on regional myocardial blood flow and metabolism during cardiopulmonary bypass. III. Effects of temperature, time, and perfusion pressure in fibrillating hearts.</a> The Journal of Thoracic and Cardiovascular Surgery. 73 (1), 102-109 (1977).</li><li>von Planta, 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=Cardiopulmonary+resuscitation+in+the+rat.">Cardiopulmonary resuscitation in the rat.</a> Journal of Applied Physiology. 65 (6), 2641-2647 (1988).</li><li>Luo, 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=Ageing+increases+cardiac+electrical+remodelling+in+rats+and+mice+via+NOX4/ROS/CaMKII-mediated+calcium+signalling.">Ageing increases cardiac electrical remodelling in rats and mice via NOX4/ROS/CaMKII-mediated calcium signalling.</a> Oxidative Medicine and Cellular Longevity. 2022, 8538296 (2022).</li><li>Hohnloser, S., Weirich, J., Antoni, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Influence+of+direct+current+on+the+electrical+activity+of+the+heart+and+on+its+susceptibility+to+ventricular+fibrillation.">Influence of direct current on the electrical activity of the heart and on its susceptibility to ventricular fibrillation.</a> Basic Research in Cardiology. 77 (3), 237-249 (1982).</li><li>Xie, 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=High-energy+defibrillation+increases+the+severity+of+postresuscitation+myocardial+dysfunction.">High-energy defibrillation increases the severity of postresuscitation myocardial dysfunction.</a> Circulation. 96 (2), 683-688 (1997).</li><li>Manoach, M., Netz, H., Erez, M., Weinstock, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ventricular+self-defibrillation+in+mammals:+Age+and+drug+dependence.">Ventricular self-defibrillation in mammals: Age and drug dependence.</a> Age and Ageing. 9 (2), 112-116 (1980).</li><li>Filippi, S., Gizzi, A., Cherubini, C., Luther, S., Fenton, F. 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Este protocolo estabelece um modelo animal de FV de longa duração em corações isolados de ratos que não foi relatado anteriormente. Além disso, diferentes condições de estimulação elétrica foram comparadas neste estudo. Este estudo fornece um modelo para estudos relacionados à parada de fibrilação ventricular durante cirurgia cardíaca.
A taxa de sucesso do modelo é um indicador muito importante que está relacionado a pessoal, tempo e custos econômicos. Em modelos de PV, a tax...

A cirurgia cardíaca geralmente é realizada por toracotomia, com bloqueio da aorta e perfusão com solução cardioplégica para parada do coração. A repetição da cirurgia cardíaca pode ser mais desafiadora do que a cirurgia inicial, com maiores taxas de complicações e mortalidade 1,2,3. Além disso, a abordagem convencional de esternotomia mediana pode causar danos aos vasos da ponte atrás do esterno, da aorta ascendente, do ventrículo direito e de outras estruturas importantes. Sangramento extenso devido à separação do tecido conjuntivo, infecção da ferida esternal e osteomielite esternal devido à esternotomia são complicações possíveis. A dissecção extensa aumenta o risco de lesões e hemorragia em estruturas cardíacas vitais.
Com o desenvolvimento da cirurgia cardíaca minimamente invasiva, as incisões tornaram-se menores, e a parada cardíaca às vezes é difícil de alcançar. A repetição de cirurgia cardíaca sob fibrilação ventricular (FV)4,5 é segura, factível e pode proporcionar melhor proteção miocárdica. Portanto, este protocolo introduz o método de parada cardíaca de PV em cirurgia com circulação extracorpórea minimamente invasiva. O coração perde contração efetiva durante a PV e, assim, não há necessidade de sutura e bloqueio da aorta ascendente durante a cirurgia, o que simplifica o procedimento. No entanto, mesmo que o coração seja continuamente perfundido, a PV a longo prazo ainda pode ser prejudicial ao coração.
À medida que esse método se torna mais amplamente utilizado, a questão de como proteger o coração durante a PV torna-se cada vez mais relevante. Isso exigirá estudos extensivos e aprofundados utilizando modelos animais de FV de longa duração. No passado, as pesquisas nessa área utilizaram principalmente animais de grande porte6,7 e exigiram cooperação entre cirurgiões, anestesiologistas, perfusionistas e outros pesquisadores. Esses estudos demoraram muito, os tamanhos amostrais foram muitas vezes pequenos, e os estudos geralmente se concentraram na função cardíaca e menos em avaliações mecanicistas e moleculares. Até o momento, nenhum estudo relatou um protocolo detalhado para estabelecer um modelo de PV de longa duração.
Este protocolo, portanto, fornece os detalhes necessários para o desenvolvimento de um modelo de PV de longo prazo em ratos usando o aparelho de Langendorff. O protocolo é simples, econômico, repetível e estável.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>0 Non-absorbable suture</td>
			<td>Ethicon, Inc.</td>
			<td></td>
			<td>Preparation of the isolated heart</td>
		</tr>
		<tr>
			<td>95% O2 + 5% CO2</td>
			<td>Beijing BeiYang United Gas Co., Ltd.&#160;</td>
			<td></td>
			<td>K-H buffer</td>
		</tr>
		<tr>
			<td>AcqKnowledge software</td>
			<td>BIOPAC Systems Inc.</td>
			<td>Version 4.2.1</td>
			<td>Software</td>
		</tr>
		<tr>
			<td>Automatic biochemistry analyzer</td>
			<td>Rayto Life and Analytical Sciences Co., Ltd.</td>
			<td>Chemray 800</td>
			<td>CK-MB assay</td>
		</tr>
		<tr>
			<td>BIOPAC research systems</td>
			<td>BIOPAC Systems Inc.</td>
			<td>MP150</td>
			<td>Hardware</td>
		</tr>
		<tr>
			<td>Blunt needle (20 G, TWLB)</td>
			<td>Tianjin Hanaco MEDICAL Co., Ltd.</td>
			<td>H-113AP-S</td>
			<td>Modified Langendorff perfusion system</td>
		</tr>
		<tr>
			<td>Calcium chloride</td>
			<td>Sinopharm Chemical Reagent Co.,Ltd</td>
			<td>10005861</td>
			<td>K-H buffer</td>
		</tr>
		<tr>
			<td>CK-MB assay kits&#160;</td>
			<td>Changchun Huili Biotech Co., Ltd.</td>
			<td>C060</td>
			<td>CK-MB assay</td>
		</tr>
		<tr>
			<td>Curved forcep</td>
			<td>Shanghai Medical Instrument (Group) Co., Ltd.</td>
			<td></td>
			<td>Preparation of the isolated heart</td>
		</tr>
		<tr>
			<td>EDTA</td>
			<td>Sinopharm Chemical Reagent Co.,Ltd</td>
			<td>10009717</td>
			<td>K-H buffer</td>
		</tr>
		<tr>
			<td>Electrical stimulator</td>
			<td>BIOPAC Systems Inc.</td>
			<td>STEMISOC</td>
			<td>Hardware</td>
		</tr>
		<tr>
			<td>Filter</td>
			<td>Tianjin Hanaco MEDICAL Co., Ltd.</td>
			<td>H-113AP-S</td>
			<td></td>
		</tr>
		<tr>
			<td>Glucose</td>
			<td>Sinopharm Chemical Reagent Co.,Ltd</td>
			<td>63005518</td>
			<td>K-H buffer</td>
		</tr>
		<tr>
			<td>Heparin sodium</td>
			<td>Tianjin Biochem Pharmaceutical Co., Ltd.</td>
			<td>H120200505</td>
			<td>Preparation of the isolated heart</td>
		</tr>
		<tr>
			<td>Isoflurane</td>
			<td>RWD Life Science Co.,LTD</td>
			<td>21082201</td>
			<td>Preparation of the isolated heart</td>
		</tr>
		<tr>
			<td>Magnesium sulfate</td>
			<td>Sinopharm Chemical Reagent Co.,Ltd</td>
			<td>20025118</td>
			<td>K-H buffer</td>
		</tr>
		<tr>
			<td>Needle electrodes</td>
			<td>BIOPAC Systems Inc.</td>
			<td>EL452</td>
			<td>Hardware</td>
		</tr>
		<tr>
			<td>Ophthalmic clamp</td>
			<td>Shanghai Medical Instrument (Group) Co., Ltd.</td>
			<td></td>
			<td>Preparation of the isolated heart</td>
		</tr>
		<tr>
			<td>Ophthalmic forceps</td>
			<td>Shanghai Medical Instrument (Group) Co., Ltd.</td>
			<td></td>
			<td>Preparation of the isolated heart</td>
		</tr>
		<tr>
			<td>Ophthalmic scissors</td>
			<td>Shanghai Medical Instrument (Group) Co., Ltd.</td>
			<td></td>
			<td>Preparation of the isolated heart</td>
		</tr>
		<tr>
			<td>Perfusion tube</td>
			<td>Tianjin Hanaco MEDICAL Co., Ltd.</td>
			<td>H-113AP-S</td>
			<td>Modified Langendorff perfusion system</td>
		</tr>
		<tr>
			<td>Potassium chloride</td>
			<td>Sinopharm Chemical Reagent Co.,Ltd</td>
			<td>10016318</td>
			<td>K-H buffer</td>
		</tr>
		<tr>
			<td>Sodium bicarbonate</td>
			<td>Sinopharm Chemical Reagent Co.,Ltd</td>
			<td>10018960</td>
			<td>K-H buffer</td>
		</tr>
		<tr>
			<td>Sodium chloride</td>
			<td>Sinopharm Chemical Reagent Co.,Ltd</td>
			<td>10019318</td>
			<td>K-H buffer</td>
		</tr>
		<tr>
			<td>Sodium dihydrogen phosphate dihydrate</td>
			<td>Sinopharm Chemical Reagent Co.,Ltd</td>
			<td>20040718</td>
			<td>K-H buffer</td>
		</tr>
		<tr>
			<td>Sprague-Dawley (SD) rats</td>
			<td>SPF (Beijing) biotechnology Co., Ltd.</td>
			<td>Male, 300-350g</td>
			<td>Preparation of the isolated heart</td>
		</tr>
		<tr>
			<td>Thermometer</td>
			<td>Jiangsu Jingchuang Electronics Co., Ltd.</td>
			<td>GSP-6</td>
			<td>Modified Langendorff perfusion system</td>
		</tr>
		<tr>
			<td>Tissueforceps</td>
			<td>Shanghai Medical Instrument (Group) Co., Ltd.</td>
			<td></td>
			<td>Preparation of the isolated heart</td>
		</tr>
		<tr>
			<td>Tissue scissors</td>
			<td>Shanghai Medical Instrument (Group) Co., Ltd.</td>
			<td></td>
			<td>Preparation of the isolated heart</td>
		</tr>
		<tr>
			<td>Toothed forceps</td>
			<td>Shanghai Medical Instrument (Group) Co., Ltd.</td>
			<td></td>
			<td>Preparation of the isolated heart</td>
		</tr>
		<tr>
			<td>Ventilator</td>
			<td>Chengdu Instrument Factory</td>
			<td>DKX-150</td>
			<td>Preparation of the isolated heart</td>
		</tr>
		<tr>
			<td>Water bath1</td>
			<td>Ningbo Scientz Biotechnology Co.,Ltd.</td>
			<td>SC-15</td>
			<td>Modified Langendorff perfusion system</td>
		</tr>
		<tr>
			<td>Water bath2</td>
			<td>Shanghai Yiheng Technology Instrument Co., Ltd.</td>
			<td>DK-8D</td>
			<td>Modified Langendorff perfusion system</td>
		</tr>
	</tbody>
</table>

a model of long-term ventricular fibrillation in isolated rat hearts

A fibrilação ventricular (FV) é uma arritmia fatal com alta incidência em pacientes cardíacos, mas a parada da PV sob perfusão é um método negligenciado de parada intraoperatória no campo da cirurgia cardíaca. Com os recentes avanços da cirurgia cardíaca, a demanda por estudos prolongados de PV sob perfusão tem aumentado. Entretanto, o campo carece de modelos animais simples, confiáveis e reprodutíveis de fibrilação ventricular crônica. Esse protocolo induz a PV de longa duração por meio da estimulação elétrica do epicárdio em corrente alternada (CA). Diferentes condições foram utilizadas para induzir a PV, incluindo estimulação contínua com baixa ou alta voltagem para induzir FV de longa duração e estimulação por 5 min com baixa ou alta voltagem para induzir FV espontânea de longa duração. As taxas de sucesso das diferentes condições, bem como as taxas de lesão miocárdica e recuperação da função cardíaca, foram comparadas. Os resultados mostraram que a estimulação contínua de baixa voltagem induziu FV de longa duração e que 5 min de estimulação de baixa voltagem induziram FV espontânea de longa duração com lesão miocárdica leve e alta taxa de recuperação da função cardíaca. No entanto, o modelo de PV de longa duração continuamente estimulado de baixa voltagem apresentou maior taxa de sucesso. A estimulação de alta voltagem proporcionou maior taxa de indução de FV, mas mostrou baixa taxa de sucesso na desfibrilação, má recuperação da função cardíaca e lesão miocárdica grave. Com base nesses resultados, a estimulação contínua por CA epicárdica de baixa voltagem é recomendada por sua alta taxa de sucesso, estabilidade, confiabilidade, reprodutibilidade, baixo impacto na função cardíaca e leve lesão miocárdica.

Foram utilizados 57 ratos nos experimentos, dos quais 30 preencheram os critérios de inclusão. Os animais incluídos foram divididos em cinco grupos, com seis animais em cada grupo: grupo controle (Grupo C), grupo FV de longa duração continuamente estimulada por baixa voltagem (Grupo LC), grupo de FV de longa duração continuamente estimulada de alta voltagem (Grupo HC), grupo de PV espontânea de longa duração induzida por baixa voltagem (Grupo LI) e grupo de FV espontânea de longa duração induzida por alta vo...

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A Model of Long-Term Ventricular Fibrillation in Isolated Rat Hearts

Este protocolo apresenta um modelo de fibrilação ventricular de longa duração em corações de ratos induzida por estimulação contínua com corrente alternada de baixa voltagem. Esse modelo tem alta taxa de sucesso, é estável, confiável e reprodutível, tem baixo impacto na função cardíaca e causa apenas lesão miocárdica leve.

Modelo de Fibrilação Ventricular de Longa Duração em Corações Isolados de Rato

Ventricular fibrillation (VF) is a fatal arrhythmia with a high incidence in cardiac patients, but VF arrest under perfusion is a neglected method of ...

Este protocolo fornece uma necessidade detalhada para o desenvolvimento de um modelo de fibrilação ventricular de longo prazo em ratos usando o aparelho de Langendorff. Ele preenche a lacuna de fibrilação ventricular de longa duração no modelo de pequenos animais. A técnica é simples, econômica, repetível e estável.Esta técnica pode ser utilizada no estudo da parada de fibrilação ventricular sob perfusão que é realizada em determinadas situações clínicas no campo das sessões e operações de cirurgia cardíaca. Para começar, prepare o tampão Krebs-Henseleit ou KH adicionando 118 milimolares de cloreto de sódio, 4,7 milimolares de cloreto de potássio, 1,2 milimolar de cloreto de magnésio, 1,2 milimolar de dihidrogenofosfato de sódio, 1,8 milimolar de cloreto de cálcio, 25 milimolares de bicarbonato de sódio, 11,1 milimolar de glicose e 0,5 milimolar EDTA em água destilada. Em seguida, prepare o sistema de perfusão Langendorff modificado.Gaseificar continuamente o balão contendo tampão KH com 95% de oxigénio e 5% de dióxido de carbono a uma pressão de aproximadamente 80 milímetros de mercúrio. Coloque uma extremidade do tubo de perfusão no tampão KH, passe o meio do tubo de perfusão através do banho-maria e prenda uma agulha romba de calibre 20 na outra extremidade do tubo de perfusão. Depois de suspender a agulha em um suporte de arame, ajuste a temperatura do banho-maria de modo que a temperatura do tampão KH da extremidade do sistema de perfusão seja de 37 graus Celsius.Use um gravador de sinais fisiológicos para digitalizar e gravar todos os sinais analógicos. Use dois eletrodos de agulha de aço inoxidável para registrar um eletrocardiograma ou ECG bipolar e dois eletrodos de agulha de aço inoxidável para estimulação elétrica. Conecte uma extremidade dos quatro eletrodos ao registrador de sinais fisiológicos e a outra extremidade próxima à área onde o coração será posicionado após a fixação ao aparelho.Em seguida, use o software do laptop para reconhecer, ajustar e registrar automaticamente parâmetros bipolares de ECG e hemodinâmica. Ajuste os parâmetros do estimulador elétrico para corrente alternada de 30 hertz com o grupo de baixa tensão recebendo 2 volts e o grupo de alta tensão recebendo 6 volts. Com o rato anestesiado conectado a um ventilador após dissecção cervical e intubação traqueal, levante a pele do processo xifoide com pinça dentada e faça uma incisão transversal de três centímetros na pele com tesoura de tecido.Estenda as incisões da pele e das costelas até as axilas de ambos os lados em forma de V. Use dissecção romba para separar o tronco braquiocefálico do tecido circundante. Em seguida, pinça o tronco braquiocefálico com pinça curva para facilitar a remoção do coração.Mergulhe imediatamente o coração em uma placa de Petri com tampão KH a 0 a 4 graus Celsius para lavar e bombear o sangue residual. Transfira o coração para uma segunda placa de Petri. Cortar o tecido redundante e identificar a aorta.Use duas pinças oftálmicas para levantar a aorta e inserir a aorta na agulha romba do aparelho de Langendorff. Em seguida, com a ajuda de um assistente, amarre um nó com um fio de sutura 0. Ligue o regulador de fluxo de perfusão.Empurre o balão através da válvula mitral para o ventrículo esquerdo. Encha o balão com água destilada para atingir uma pressão diastólica final de 5 a 10 milímetros de mercúrio. Conecte o ECG e os eletrodos de estimulação elétrica ao coração.Coloque o coração no centro da câmara de vidro encamisado mantido a 37 graus Celsius. Deixe o coração se equilibrar por 20 minutos dentro da câmara. Em seguida, ajuste a temperatura do banho-maria para manter a temperatura dentro da câmara de vidro encamisada em 30 graus Celsius.Depois que a temperatura atingir o nível desejado, ative o interruptor de estimulação elétrica no software do laptop. Se o animal fizer parte do grupo fibrilação ventricular de longa duração ou FV continuamente estimulada, permitir 90 minutos de estimulação elétrica. Após 90 minutos de FV, utilizar eletrodos para dar 0,1 joule de desfibrilação por corrente contínua.Simultaneamente, regule a temperatura do banho-maria para permitir que a temperatura suba lentamente dentro da câmara de vidro encamisado para 37 graus Celsius por 10 minutos. Após a desfibrilação, deixe o coração bater por 60 minutos e, em seguida, pare o batimento por perfusão lenta com cloreto de potássio a 10% a aproximadamente 37 graus Celsius. Remover o coração para dosagem de creatina quinase ou CK-MB e análise histológica.As taxas de FV, a taxa de sucesso da desfibrilação e a taxa de sucesso do modelo de FV são mostradas aqui. O Grupo LC e o Grupo HC receberam estimulação elétrica contínua e, assim, a PV ocorreu com 100% de sucesso. Já o grupo HC demonstrou menores taxas de sucesso para a desfibrilação.O Grupo LI e o Grupo HI, nos quais a estimulação elétrica foi desligada após cinco minutos, apresentaram diferentes taxas de FV, mas a taxa de PV foi mais lenta em ambos os grupos em comparação com o Grupo LC e o Grupo HC. Tanto o Grupo LC quanto o Grupo LI apresentaram melhores taxas de sucesso na desfibrilação. Mas, no geral, o Grupo LC teve a maior taxa de sucesso do modelo, enquanto o Grupo LI teve uma menor taxa de sucesso do modelo. A frequência cardíaca ou FC, o fluxo coronariano ou FC e a diferença de pressão ventricular esquerda ou taxas de recuperação da DPVE são mostrados aqui.A hemodinâmica do Grupo C manteve-se estável durante o experimento e mostrou discreta diminuição da FC, FC e DLVE. Os dois grupos com PV induzida por baixa voltagem apresentaram desempenho semelhante e boa taxa de recuperação. A FC e a DLVE não foram significativamente diferentes nesses grupos em comparação com o Grupo C. Mas a taxa de recuperação da FC foi significativamente melhor do que no Grupo C.In contraste, a taxa de recuperação hemodinâmica dos dois grupos com alta voltagem induzida à FV de longa duração foi pobre e o grupo de FV de longa duração continuamente estimulada de alta voltagem mostrou a pior taxa de recuperação.A análise dos fluidos de derrame coronariano mostrou que os níveis de CK-MB foram maiores em ambos os grupos de alta voltagem. Não foram encontradas diferenças entre os dois grupos de baixa voltagem e o Grupo C. A coloração de hematoxilina e eosina mostrou uma região de queimadura do eletrodo no Grupo HC. Este protocolo é adequado para estudo relacionado à parada de fibrilação ventricular e à perfusão em cirurgia cardiovascular.

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Research

JoVE Journal

Medicine

Assessment of Cardiac Function and Energetics in Isolated Mouse Hearts Using 31P NMR Spectroscopy

Bioengineered mouse models have become powerful research tools in determining causal relationships between molecular alterations and models of cardiovascular disease. Although molecular biology is necessary in identifying key changes in the signaling pathway, it is not a surrogate for functional significance. While physiology can provide answers to the question of function, combining physiology with biochemical assessment of metabolites in the intact, beating heart allows for a complete picture of cardiac function and energetics. For years, our laboratory has utilized isolated heart perfusions combined with nuclear magnetic resonance (NMR) spectroscopy to accomplish this task. Left ventricular function is assessed by Langendorff-mode isolated heart perfusions while cardiac energetics is measured by performing 31P magnetic resonance spectroscopy of the perfused hearts. With these techniques, indices of cardiac function in combination with levels of phosphocreatine and ATP can be measured simultaneously in beating hearts. Furthermore, these parameters can be monitored while physiologic or pathologic stressors are instituted. For example, ischemia/reperfusion or high workload challenge protocols can be adopted. The use of aortic banding or other models of cardiac pathology are apt as well. Regardless of the variants within the protocol, the functional and energetic significance of molecular modifications of transgenic mouse models can be adequately described, leading to new insights into the associated enzymatic and metabolic pathways. Therefore, 31P NMR spectroscopy in the isolated perfused heart is a valuable research technique in animal models of cardiovascular disease.

Assessment of Cardiac Function and Energetics in Isolated Mouse Hearts Using 31P NMR Spectroscopy

Langendorff-mode isolated heart perfusion, in conjunction with 31P NMR spectroscopy, combines the fields of biochemistry and physiology into one experiment. The protocol allows for the dynamic measurement of high energy phosphate content and turnover in the heart while concurrently monitoring physiologic function. When performed correctly, this is a valuable technique in the assessment of cardiac energetics.

Avaliação da função cardíaca e Energetics em Corações Isolados rato Usando 31 P NMR Spectroscopy

Bioengineered mouse models have become powerful research tools in determining causal relationships between molecular alterations and models of ...

Medicina

NADH Fluorescence Imaging of Isolated Biventricular Working Rabbit Hearts

Since its inception by Langendorff1, the isolated perfused heart remains a prominent tool for studying cardiac physiology2. However, it is not well-suited for studies of cardiac metabolism, which require the heart to perform work within the context of physiologic preload and afterload pressures. Neely introduced modifications to the Langendorff technique to establish appropriate left ventricular (LV) preload and afterload pressures3. The model is known as the isolated LV working heart model and has been used extensively to study LV performance and metabolism4-6. This model, however, does not provide a properly loaded right ventricle (RV). Demmy et al. first reported a biventricular model as a modification of the LV working heart model7, 8. They found that stroke volume, cardiac output, and pressure development improved in hearts converted from working LV mode to biventricular working mode8. A properly loaded RV also diminishes abnormal pressure gradients across the septum to improve septal function. Biventricular working hearts have been shown to maintain aortic output, pulmonary flow, mean aortic pressure, heart rate, and myocardial ATP levels for up to 3 hours8.
When studying the metabolic effects of myocardial injury, such as ischemia, it is often necessary to identify the location of the affected tissue. This can be done by imaging the fluorescence of NADH (the reduced form of nicotinamide adenine dinucleotide)9-11, a coenzyme found in large quantities in the mitochondria. NADH fluorescence (fNADH) displays a near linearly inverse relationship with local oxygen concentration12 and provides a measure of mitochondrial redox state13. fNADH imaging during hypoxic and ischemic conditions has been used as a dye-free method to identify hypoxic regions14, 15 and to monitor the progression of hypoxic conditions over time10.
The objective of the method is to monitor the mitochondrial redox state of biventricular working hearts during protocols that alter the rate of myocyte metabolism or induce hypoxia or create a combination of the two. Hearts from New Zealand white rabbits were connected to a biventricular working heart system (Hugo Sachs Elektronik) and perfused with modified Krebs-Henseleit solution16 at 37 &deg;C. Aortic, LV, pulmonary artery, and left &amp; right atrial pressures were recorded. Electrical activity was measured using a monophasic action potential electrode. To image fNADH, light from a mercury lamp was filtered (350&plusmn;25 nm) and used to illuminate the epicardium. Emitted light was filtered (460&plusmn;20 nm) and imaged using a CCD camera. Changes in the epicardial fNADH of biventricular working hearts during different pacing rates are presented. The combination of the heart model and fNADH imaging provides a new and valuable experimental tool for studying acute cardiac pathologies within the context of realistic physiological conditions.

The objective is to monitor the mitochondrial redox state of isolated hearts within the context of physiologic preload and afterload pressures. A biventricular working rabbit heart model is presented. High spatiotemporal resolution fluorescence imaging of NADH is used to monitor the mitochondrial redox state of epicardial tissue.

NADH Fluorescência de Imagem biventricular isolado de coelho

Since its inception by Langendorff1, the isolated perfused heart remains a prominent tool for studying cardiac physiology2. However, it is not well-suited ...

Reduction in Left Ventricular Wall Stress and Improvement in Function in Failing Hearts using Algisyl-LVR

Injection of Algisyl-LVR, a treatment under clinical development, is intended to treat patients with dilated cardiomyopathy. This treatment was recently used for the first time in patients who had symptomatic heart failure. In all patients, cardiac function of the left ventricle (LV) improved significantly, as manifested by consistent reduction of the LV volume and wall stress. Here we describe this novel treatment procedure and the methods used to quantify its effects on LV wall stress and function.
Algisyl-LVR is a biopolymer gel consisting of Na+-Alginate and Ca2+-Alginate. The treatment procedure was carried out by mixing these two components and then combining them into one syringe for intramyocardial injections. This mixture was injected at 10 to 19 locations mid-way between the base and apex of the LV free wall in patients.
Magnetic resonance imaging (MRI), together with mathematical modeling, was used to quantify the effects of this treatment in patients before treatment and at various time points during recovery. The epicardial and endocardial surfaces were first digitized from the MR images to reconstruct the LV geometry at end-systole and at end-diastole. Left ventricular cavity volumes were then measured from these reconstructed surfaces.
Mathematical models of the LV were created from these MRI-reconstructed surfaces to calculate regional myofiber stress. Each LV model was constructed so that 1) it deforms according to a previously validated stress-strain relationship of the myocardium, and 2) the predicted LV cavity volume from these models matches the corresponding MRI-measured volume at end-diastole and end-systole. Diastolic filling was simulated by loading the LV endocardial surface with a prescribed end-diastolic pressure. Systolic contraction was simulated by concurrently loading the endocardial surface with a prescribed end-systolic pressure and adding active contraction in the myofiber direction. Regional myofiber stress at end-diastole and end-systole was computed from the deformed LV based on the stress-strain relationship.

This article describes procedures for implanting a novel hydrogel in failing hearts and quantifying its effect on left ventricular wall stress and function. These procedures have been successfully applied in dogs and humans.

Redução do Ventrículo Esquerdo de parede Estresse e Melhoria na função em falta Corações usando Algisyl-LVR

Injection of  Algisyl-LVR, a treatment under clinical development, is intended to treat  patients with dilated cardiomyopathy. This treatment was recently ...

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

The number of acceptable donor lungs available for lung transplantation is severely limited due to poor quality. Ex-Vivo Lung Perfusion (EVLP) has allowed lung transplantation in humans to become more readily available by enabling the ability to assess organs and expand the donor pool. As this technology expands and improves, the ability to potentially evaluate and improve the quality of substandard lungs prior to transplant is a critical need. In order to more rigorously evaluate these approaches, a reproducible animal model needs to be established that would allow for testing of improved techniques and management of the donated lungs as well as to the lung-transplant recipient. In addition, an EVLP animal model of associated pathologies, e.g., ventilation induced lung injury (VILI), would provide a novel method to evaluate treatments for these pathologies. Here, we describe the development of a rat EVLP lung program and refinements to this method that allow for a reproducible model for future expansion. We also describe the application of this EVLP system to model VILI in rat lungs. The goal is to provide the research community with key information and &#8220;pearls of wisdom&#8221;/techniques that arose from trial and error and are critical to establishing an EVLP system that is robust and reproducible.

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

Ex-Vivo Lung Perfusion (EVLP) has allowed lung transplantation in humans to become more readily available by enabling the ability to assess organs and expand the donor pool. Here, we describe the development of a rat EVLP program and refinements that allow for a reproducible model for future expansion.

Método de Isolado<em&gt; Ex Vivo</em&gt; Perfusão pulmonar em um modelo de rato: Lições aprendidas com o desenvolvimento de um Programa PPEV Rat

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

A Rat Model of Ventricular Fibrillation and Resuscitation by Conventional Closed-chest Technique

A rat model of electrically-induced ventricular fibrillation followed by cardiac resuscitation using a closed chest technique that incorporates the basic components of cardiopulmonary resuscitation in humans is herein described. The model was developed in 1988 and has been used in approximately 70 peer-reviewed publications examining a myriad of resuscitation aspects including its physiology and pathophysiology, determinants of resuscitability, pharmacologic interventions, and even the effects of cell therapies. The model featured in this presentation includes: (1) vascular catheterization to measure aortic and right atrial pressures, to measure cardiac output by thermodilution, and to electrically induce ventricular fibrillation; and (2) tracheal intubation for positive pressure ventilation with oxygen enriched gas and assessment of the end-tidal CO2. A typical sequence of intervention entails: (1) electrical induction of ventricular fibrillation, (2) chest compression using a mechanical piston device concomitantly with positive pressure ventilation delivering oxygen-enriched gas, (3) electrical shocks to terminate ventricular fibrillation and reestablish cardiac activity, (4) assessment of post-resuscitation hemodynamic and metabolic function, and (5) assessment of survival and recovery of organ function. A robust inventory of measurements is available that includes &#8211; but is not limited to &#8211; hemodynamic, metabolic, and tissue measurements. The model has been highly effective in developing new resuscitation concepts and examining novel therapeutic interventions before their testing in larger and translationally more relevant animal models of cardiac arrest and resuscitation.

This article describes a rat model of electrically-induced ventricular fibrillation and resuscitation by chest compression, ventilation, and delivery of electrical shocks that simulates an episode of sudden cardiac arrest and conventional cardiopulmonary resuscitation. The model enables gathering insights on the pathophysiology of cardiac arrest and exploration of new resuscitation strategies.

Um modelo de rato de Fibrilação Ventricular e Reanimação por Técnica de tórax fechado convencional

A rat model of electrically-induced ventricular fibrillation followed by cardiac resuscitation using a closed chest technique that incorporates the basic ...

Induction and Assessment of Ischemia-reperfusion Injury in Langendorff-perfused Rat Hearts

The biochemical events surrounding ischemia reperfusion injury in the acute setting are of great importance to furthering novel treatment options for myocardial infarction and cardiac complications of thoracic surgery. The ability of certain drugs to precondition the myocardium against ischemia reperfusion injury has led to multiple clinical trials, with little success. The isolated heart model allows acute observation of the functional effects of ischemia reperfusion injury in real time, including the effects of various pharmacological interventions administered at any time-point before or within the ischemia-reperfusion injury window. Since brief periods of ischemia can precondition the heart against ischemic injury, in situ aortic cannulation is performed to allow for functional assessment of non-preconditioned myocardium. A saline filled balloon is placed into the left ventricle to allow for real-time measurement of pressure generation. Ischemic injury is simulated by the cessation of perfusion buffer flow, followed by reperfusion. The duration of both ischemia and reperfusion can be modulated to examine biochemical events at any given time-point. Although the Langendorff isolated heart model does not allow for the consideration of systemic events affecting ischemia and reperfusion, it is an excellent model for the examination of acute functional and biochemical events within the window of ischemia reperfusion injury as well as the effect of pharmacological intervention on cardiac pre- and postconditioning. The goal of this protocol is to demonstrate how to perform in situ aortic cannulation and heart excision followed by ischemia/reperfusion injury in the Langendorff model.

The isolated rat heart is an enduring model for ischemia reperfusion injury. Here, we describe the process of harvesting the beating heart from a rat via in situ aortic cannulation, Langendorff perfusion of the heart, simulated ischemia-reperfusion injury, and infarct staining to confirm the extent of ischemic insult.

Indução e Avaliação de isquemia-reperfusão em Langendorff-perfundidos Rato Corações

The biochemical events surrounding ischemia reperfusion injury in the acute setting are of great importance to furthering novel treatment options for ...

Surgical Placement of Catheters for Long-term Cardiovascular Exercise Testing in Swine

This protocol describes the surgical procedure to chronically instrument swine and the procedure to exercise swine on a motor-driven treadmill. Early cardiopulmonary dysfunction is difficult to diagnose, particularly in animal models, as cardiopulmonary function is often measured invasively, requiring anesthesia. As many anesthetic agents are cardiodepressive, subtle changes in cardiovascular function may be masked. In contrast, chronic instrumentation allows for measurement of cardiopulmonary function in the awake state, so that measurements can be obtained under quiet resting conditions, without the effects of anesthesia and acute surgical trauma. Furthermore, when animals are properly trained, measurements can also be obtained during graded treadmill exercise.
Flow probes are placed around the aorta or pulmonary artery for measurement of cardiac output and around the left anterior descending coronary artery for measurement of coronary blood flow. Fluid-filled catheters are implanted in the aorta, pulmonary artery, left atrium, left ventricle and right ventricle for pressure measurement and blood sampling. In addition, a 20 G&#160;catheter is positioned in the anterior interventricular vein to allow coronary venous blood sampling.
After a week of recovery, swine are placed on a motor-driven treadmill, the catheters are connected to pressure and flow meters, and swine are subjected to a five-stage progressive exercise protocol, with each stage lasting 3 min. Hemodynamic signals are continuously recorded and blood samples are taken during the last 30 sec of each exercise stage.
The major advantage of studying chronically instrumented animals is that it allows serial assessment of cardiopulmonary function, not only at rest but also during physical stress such as exercise. Moreover, cardiopulmonary function can be assessed repeatedly during disease development and during chronic treatment, thereby increasing statistical power and hence limiting the number of animals required for a study.

Here we present a protocol to assess cardiopulmonary function in awake swine, at rest and during graded treadmill exercise. Chronic instrumentation allows for repeated hemodynamic measurements uninfluenced by cardiodepressive anesthetic agents.

Cirurgia de colocação de cateteres para Cardiovascular Testes exercício de longo prazo em Suínos

This protocol describes the surgical procedure to chronically instrument swine and the procedure to exercise swine on a motor-driven treadmill. Early ...

Long-term Blood Pressure Measurement in Freely Moving Mice Using Telemetry

During the development of new vasoactive agents, arterial blood pressure monitoring is crucial for evaluating the efficacy of the new proposed drugs. Indeed, research focusing on the discovery of new potential therapeutic targets using genetically altered mice requires a reliable, long-term assessment of the systemic arterial pressure variation. Currently, the gold standard for obtaining long-term measurements of blood pressure in ambulatory mice uses implantable radio-transmitters, which require&#160;artery cannulation. This technique eliminates the need for tethering, restraining, or anesthetizing the animals which introduce stress and artifacts during data sampling. However, arterial blood pressure monitoring in mice via catheterization can be rather challenging due to the small size of the arteries. Here we present a step-by-step guide to illustrate the crucial key passages for a successful subcutaneous implantation of radio-transmitters and carotid artery cannulation in mice. We also include examples of long-term blood pressure activity taken from freely moving mice after a period of post-surgery recovery. Following this procedure will allow reliable direct blood pressure recordings from multiple animals simultaneously.

The goal of this protocol is to assess systemic blood pressure in conscious freely moving mice using implantable radio-telemetry devices.

Longo prazo medição de pressão arterial em ratos movimentando-se livremente utilizar telemetria

During the development of new vasoactive agents, arterial blood pressure monitoring is crucial for evaluating the efficacy of the new proposed drugs. ...

The Inverted Heart Model for Interstitial Transudate Collection from the Isolated Rat Heart

The present protocol describes a unique approach that enables the collection of cardiac transudate (CT) from the isolated, saline-perfused rat heart. After isolation and retrograde perfusion of the heart according to the Langendorff technique, the heart is inverted into an upside-down position and is mechanically stabilized by a balloon catheter inserted into the left ventricle. Then, a thin latex cap &#8211; previously cast to match the average size of the rat heart &#8211; is placed over the epicardial surface. The outlet of the latex cap is connected to silicon tubing, with the distal opening 10 cm below the base level of the heart, creating slight suction. CT continuously produced on the epicardial surface is collected in ice-cooled vials for further analysis. The rate of CT formation ranged from 17 to 147 &#181;L/min (n = 14) in control and infarcted hearts, which represents 0.1-1% of the coronary venous effluent perfusate. Proteomic analysis and high performance liquid chromatography (HPLC) revealed that the collected CT contains a wide spectrum of proteins and purinergic metabolites.

This protocol describes a method to collect cardiac interstitial fluid from the isolated, perfused rat heart. To physically separate interstitial transudate from coronary venous effluent perfusate, the Langendorff perfused heart is inverted, and the transudate (interstitial fluid) formed on the cardiac surface is collected using a soft latex cap.

O modelo do coração invertido para a coleta de transudados intersticiais do coração de rato isolado

The present protocol describes a unique approach that enables the collection of cardiac transudate (CT) from the isolated, saline-perfused rat heart. ...

Standardized Model of Ventricular Fibrillation and Advanced Cardiac Life Support in Swine

Cardiopulmonary resuscitation after cardiac arrest, independent of its origin, is a regularly encountered medical emergency in hospitals as well as preclinical settings. Prospective randomized trials in human subjects are difficult to design and ethically ambiguous, which results in a lack of evidence-based therapies. The model presented in this report represents one of the most common causes of cardiac arrests, ventricular fibrillation, in a standardized setting in a large animal model. This allows for reproducible observations and various therapeutic interventions under clinically accurate conditions, hence facilitating the generation of better evidence and eventually the potential for improved medical treatment.

Cardiopulmonary resuscitation and defibrillation are the only effective therapeutic options during cardiac arrest caused by ventricular fibrillation. This model presents a standardized regimen to induce, assess, and treat this physiological state in a porcine model, thus providing a clinical approach with various opportunities for data collection and analysis.

Modelo padronizado de Fibrilação Ventricular e Suporte avançado de vida cardíaca em suínos

Cardiopulmonary resuscitation after cardiac arrest, independent of its origin, is a regularly encountered medical emergency in hospitals as well as ...