<meta charset="utf8"></head><body>Domuz Modellerinde Akut Hacim Aşırı Yüklenmesine Fizyolojik Tepkilerin Araştırılması

<ol>
	<li>Wise, E. 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=Hemodynamic+parameters+in+the+assessment+of+fluid+status+in+a+porcine+hemorrhage+and+resuscitation+model.">Hemodynamic parameters in the assessment of fluid status in a porcine hemorrhage and resuscitation model.</a> Anesthesiology. 134 (4), 607-616 (2021).</li><li>Rollins, K. E., Lobo, D. N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intraoperative+goal-directed+fluid+therapy+in+elective+major+abdominal+surgery:+A+meta-analysis+of+randomized+controlled+trials.">Intraoperative goal-directed fluid therapy in elective major abdominal surgery: A meta-analysis of randomized controlled trials.</a> Ann Surg. 263 (3), 465-476 (2016).</li><li>Som, A., Maitra, S., Bhattacharjee, S., Baidya, D. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Goal+directed+fluid+therapy+decreases+postoperative+morbidity+but+not+mortality+in+major+non-cardiac+surgery:+a+meta-analysis+and+trial+sequential+analysis+of+randomized+controlled+trials.">Goal directed fluid therapy decreases postoperative morbidity but not mortality in major non-cardiac surgery: a meta-analysis and trial sequential analysis of randomized controlled trials.</a> J Anesth. 31 (1), 66-81 (2017).</li><li>Xu, 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=Goal-directed+fluid+therapy+versus+conventional+fluid+therapy+in+colorectal+surgery:+A+meta+analysis+of+randomized+controlled+trials.">Goal-directed fluid therapy versus conventional fluid therapy in colorectal surgery: A meta analysis of randomized controlled trials.</a> Int J Surg. 56, 264-273 (2018).</li><li>Hassinger, A. B., Wald, E. L., Goodman, 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=Early+postoperative+fluid+overload+precedes+acute+kidney+injury+and+is+associated+with+higher+morbidity+in+pediatric+cardiac+surgery+patients.">Early postoperative fluid overload precedes acute kidney injury and is associated with higher morbidity in pediatric cardiac surgery patients.</a> Pediatr Crit Care Med. 15 (2), 131-138 (2014).</li><li>Chen, 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=A+global+view+of+porcine+transcriptome+in+three+tissues+from+a+full-sib+pair+with+extreme+phenotypes+in+growth+and+fat+deposition+by+paired-end+RNA+sequencing.">A global view of porcine transcriptome in three tissues from a full-sib pair with extreme phenotypes in growth and fat deposition by paired-end RNA sequencing.</a> BMC Genomics. 12, 448 (2011).</li><li>Hou, N., Du, X., Wu, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Advances+in+pig+models+of+human+diseases.">Advances in pig models of human diseases.</a> Animal Model Exp Med. 5 (2), 141-152 (2022).</li><li>Spannbauer, 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=Large+animal+models+of+heart+failure+with+reduced+ejection+fraction+(HFrEF).">Large animal models of heart failure with reduced ejection fraction (HFrEF).</a> Front Cardiovasc Med. 6, 117 (2019).</li><li>Odle, J., Lin, X., Jacobi, S. K., Kim, S. W., Stahl, C. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+suckling+piglet+as+an+agrimedical+model+for+the+study+of+pediatric+nutrition+and+metabolism.">The suckling piglet as an agrimedical model for the study of pediatric nutrition and metabolism.</a> Annu Rev Anim Biosci. 2, 419-444 (2014).</li><li>Whitaker, E. 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=A+novel,+clinically+relevant+use+of+a+piglet+model+to+study+the+effects+of+anesthetics+on+the+developing+brain.">A novel, clinically relevant use of a piglet model to study the effects of anesthetics on the developing brain.</a> Clin Transl Med. 5 (1), 2 (2016).</li><li>Gasthuys, 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=The+potential+use+of+piglets+as+human+pediatric+surrogate+for+preclinical+pharmacokinetic+and+pharmacodynamic+drug+testing.">The potential use of piglets as human pediatric surrogate for preclinical pharmacokinetic and pharmacodynamic drug testing.</a> Curr Pharm Des. 22 (26), 4069-4085 (2016).</li><li>Alobaidi, 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=Association+between+fluid+balance+and+outcomes+in+critically+ill+children:+A+systematic+review+and+meta-analysis.">Association between fluid balance and outcomes in critically ill children: A systematic review and meta-analysis.</a> JAMA Pediatr. 172 (3), 257-268 (2018).</li><li>Soler, Y. A., Nieves-Plaza, M., Prieto, M., Garcia-De Jesus, R., Suarez-Rivera, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Pediatric+risk,+injury,+failure,+loss,+end-stage+renal+disease+score+identifies+acute+kidney+injury+and+predicts+mortality+in+critically+ill+children:+a+prospective+study.">Pediatric risk, injury, failure, loss, end-stage renal disease score identifies acute kidney injury and predicts mortality in critically ill children: a prospective study.</a> Pediatr Crit Care Med. 14 (4), e189-e195 (2013).</li><li>Alessa, M. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Porcine+as+a+training+module+for+head+and+neck+microvascular+reconstruction.">Porcine as a training module for head and neck microvascular reconstruction.</a> J Vis Exp. (139), e58104 (2018).</li><li>Higgs, Z. C., Macafee, D. A., Braithwaite, B. D., Maxwell-Armstrong, C. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+Seldinger+technique:+50+years+on.">The Seldinger technique: 50 years on.</a> Lancet. 366 (9494), 1407-1409 (2005).</li><li>Cheung-Flynn, 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=Normal+saline+solutions+cause+endothelial+dysfunction+through+loss+of+membrane+integrity,+ATP+release,+and+inflammatory+responses+mediated+by+P2X7R/p38+MAPK/MK2+signaling+pathways.">Normal saline solutions cause endothelial dysfunction through loss of membrane integrity, ATP release, and inflammatory responses mediated by P2X7R/p38 MAPK/MK2 signaling pathways.</a> PLoS One. 14 (8), e0220893 (2019).</li><li>Canteras, M., Baptista-Silva, J. C. C., Cacione, D. G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transverse+versus+longitudinal+inguinotomy+for+femoral+artery+approach.">Transverse versus longitudinal inguinotomy for femoral artery approach.</a> Cochrane Database Syst Rev. 2018 (10), CD013153 (2018).</li><li>Katz, A. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+descending+limb+of+the+Starling+curve+and+the+failing+heart.">The descending limb of the Starling curve and the failing heart.</a> Circulation. 32 (6), 871-875 (1965).</li><li>Ragosta, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Textbook of Clinical Hemodynamics. , (2017).</li><li>LaFarge, C. G., Miettinen, O. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+estimation+of+oxygen+consumption.">The estimation of oxygen consumption.</a> Cardiovasc Res. 4 (1), 23-30 (1970).</li><li>Soto, F., Kleczka, J. F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cardiopulmonary+hemodynamics+in+pulmonary+hypertension:+Pressure+tracings,+waveforms,+and+more.">Cardiopulmonary hemodynamics in pulmonary hypertension: Pressure tracings, waveforms, and more.</a> Adv Pulmonary Hypertension. 7 (4), 386-393 (2008).</li><li>Helen Chum, C. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Endotracheal+intubation+in+swine.">Endotracheal intubation in swine.</a> Lab Anim. 41 (11), 309-311 (2012).</li><li>Cavallaro, F., Sandroni, C., Antonelli, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Functional+hemodynamic+monitoring+and+dynamic+indices+of+fluid+responsiveness.">Functional hemodynamic monitoring and dynamic indices of fluid responsiveness.</a> Minerva Anestesiol. 74 (4), 123-135 (2008).</li></ol>

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>1% Isoflurane</td>
			<td>Primal, Boston, MA, USA</td>
			<td>26675-46-7</td>
			<td>https://www.sigmaaldrich.com/US/en/product/aldrich/792632?gclid=Cj0KCQjw9fqnBhDSARIsAHl 
			cQYS_W-q6tS2s6LQw2Qn7Roa3TGIpTLPf5 
			2351vrhgp44foEcRozPqtYaAtvfEAL 
			w_wcB</td>
		</tr>
		<tr>
			<td>Arterial Catheter</td>
			<td>Merit Medical, South Jordan, UT, USA</td>
			<td>MAK401</td>
			<td>MAK Mini Access Kit 4F</td>
		</tr>
		<tr>
			<td>Arterial Catheter</td>
			<td>Cook Medical, Bloomington, IN, USA</td>
			<td>C-PMS-300-RA/G01908</td>
			<td>Radial Artery Catheter Set 3.0Fr./5cm</td>
		</tr>
		<tr>
			<td>Blood Pressure Amp</td>
			<td>AD Instruments, Colorado Springs, CO, USA</td>
			<td>FE117</td>
			<td>https://www.adinstruments.com/products/bp-blood-pressure-amp</td>
		</tr>
		<tr>
			<td>Central Venous Catheter Introducer</td>
			<td>Arrow International Inc, Reading, PA, USA</td>
			<td>AK-09800</td>
			<td>8.5 Fr. x 4&#34; (10 cm) Arrow-Flex</td>
		</tr>
		<tr>
			<td>Central Venous Catheter-Introducer</td>
			<td>Arrow International</td>
			<td>CP-07611-P</td>
			<td>Super Arrow-Flex Percutaneous Sheath Introducer Kit 6Fr./7.5cm</td>
		</tr>
		<tr>
			<td>Disposable BP Transducers</td>
			<td>AD Instruments, Colorado Springs, CO, USA</td>
			<td>MLT0670</td>
			<td>https://www.adinstruments.com/products/disposable-bp-transducers</td>
		</tr>
		<tr>
			<td>Kendall 930 FoamElectrodes</td>
			<td>Covidien, Mansfield, MA, USA</td>
			<td>22935</td>
			<td>https://www.cardinalhealth.com/en/product-solutions/medical/patient-monitoring/electrocardiography/monitoring-ecg-electrodes/radiolucent-electrodes/kendall-930-series-radiolucent-foam-electrodes.html</td>
		</tr>
		<tr>
			<td>LabChart 8 software</td>
			<td>AD Instruments, Colorado Springs, CO, USA</td>
			<td>N/A</td>
			<td>https://www.adinstruments.com/products/labchart</td>
		</tr>
		<tr>
			<td>Peripheral IV Catheter Angiocath 18-24 Gauge 1.16 inch</td>
			<td>McKesson, Irving, TX, USA</td>
			<td>329830</td>
			<td>https://mms.mckesson.com/product/329830/Becton-Dickinson-381144</td>
		</tr>
		<tr>
			<td>PlamaLyte Crystilloid Solution</td>
			<td>Baxter International, Deerfield, IL USA</td>
			<td>2B2544X</td>
			<td>https://www.ciamedical.com/baxter-2b2544x-each-solution-plasma-lyte-a-inj-ph-7-4-1000ml</td>
		</tr>
		<tr>
			<td>PowerLab</td>
			<td>ADInstruments, Colorado Springs, CO, USA</td>
			<td>N/A</td>
			<td>https://www.adinstruments.com/products/powerlab/c?creative=532995768429&#38;keyword= 
			powerlab&#38;matchtype=e&#38;network= 
			g&#38;device=c&#38;gclid=CjwKCAjwysipB 
			hBXEiwApJOcu-ulfO0bfCc-j6B7PpO 
			kOAGur8IZ4SWNkhNZ7mORGstO 
			vKON6plWLxoCigsQAvD_BwE</td>
		</tr>
		<tr>
			<td>Pulmonary Artery Catheter</td>
			<td>Edwards Life Sciences, Irvine, CA, USA</td>
			<td>TS105F5</td>
			<td>True Size Thermodilution Catheter 24cm Proximal Port- Swan Ganz&#160;</td>
		</tr>
		<tr>
			<td>Pulmonary Artery Catheter (7F)</td>
			<td>Edwards Life Sciences, Irvine, CA, USA</td>
			<td>131F7</td>
			<td>Swan Ganz 7F x 110cm&#160;</td>
		</tr>
		<tr>
			<td>Telazol (Tiletamine HCl and Zolazepam HCl), Injectable Solution, 5 mL</td>
			<td>Patterson Veterinary, Loveland, CO 80538</td>
			<td>07-801-4969</td>
			<td>https://www.pattersonvet.com/ProductItem/078014969?omni=telazol</td>
		</tr>
		<tr>
			<td>Terumo Sarns 8000 Roller Pump</td>
			<td>Terumo Cardiovascular, Ann Arbor, MI, USA</td>
			<td>16402</td>
			<td>https://aamedicalstore.com/products/terumo-sarns%E2%84%A2-8000-roller-pump</td>
		</tr>
		<tr>
			<td>Xylazine HCl 100 mg/mL, Injectable Solution, 50 mL</td>
			<td>Patterson Veterinary, Loveland, CO 80538</td>
			<td>07-894-5244</td>
			<td>https://www.pattersonvet.com/ProductItem/078945244</td>
		</tr>
		<tr>
			<td>Yorkshire Adult Pigs</td>
			<td>Oak Hill Genetics, Ewing, IL, USA</td>
			<td>N/A</td>
			<td>Yorkshire/Landrace 81-100lbs</td>
		</tr>
		<tr>
			<td>Yorkshire Piglets</td>
			<td>Oak Hill Genetics&#160;</td>
			<td>N/A</td>
			<td>Female &#34;piglet&#34;, specify age 5 weeks with a correlating healthy weight range (approximately 10-20lbs.)</td>
		</tr>
	</tbody>
</table>

adult and pediatric porcine model of acute volume overload

Acute volume overload, a condition characterized by an abrupt and excessive increase in body fluid volume, is a critical medical concern that warrants comprehensive study1. It is often associated with aggressive and/or inappropriate fluid resuscitation, blood transfusion, and comorbidities such as heart failure and renal failure. It can lead to severe morbidity and an increased likelihood of mortality1,2,3. Despite its clinical significance, the pathophysiology of acute volume overload remains poorly understood3,4. Furthermore, the lack of specific diagnostic criteria and effective monitoring strategies further underscores the need for rigorous scientific investigation. Studying acute volume overload is not only crucial for improving patient outcomes but also for advancing our understanding of human physiology. It provides a unique opportunity to explore the body&#39;s fluid homeostasis mechanisms and their responses to extreme stress1. Studies investigating goal-directed fluid therapy (GDFT) to prevent liberal fluid resuscitation and promote a more goal-directed resuscitation approach have demonstrated improved morbidity and mortality in perioperative settings and in sepsis1,3,4. These studies used a variety of devices to monitor the volume state, including central venous catheters with central venous pressure measurements, ScVO2, arterial line lactate measurements, stroke volume/cardiac output measurements through transesophageal Doppler, lithium dilution cardiac output, arterial pulse contour analysis, thoracic electrical bioimpedance, and transpulmonary thermodilution1,3,4,5. The multiple approaches utilized to assess volume status, each with limitations in accuracy and usability, suggest that there is room for significant improvement in GDFT by enhancing intravascular volume assessment3,4.
Porcine models have emerged as particularly valuable tools in the study of human cardiovascular physiology6. The anatomical and physiological similarities between porcine and human cardiovascular systems, such as heart size, coronary anatomy, and hemodynamic parameters, make pigs ideal models for translational research6. Furthermore, pigs exhibit a comparable response to volume overload as humans, making them excellent models for studying the pathophysiology of acute volume overload and the effectiveness of various therapeutic interventions7,8. The use of porcine models also allows for the collection of high-quality, detailed data points, such as real-time hemodynamic measurements and tissue samples, which are often unattainable in human studies7. This superiority of data points provides a more comprehensive understanding of acute volume overload, which could ultimately contribute to the development of more effective monitoring and prevention strategies.
The use of piglet models in studying acute volume overload is of paramount importance, particularly given the scarcity of pediatric research in this field. Piglets, with their physiological and developmental similarities to human infants, provide an invaluable model, like their adult counterparts, for understanding the pediatric population9,10,11. Despite the high incidence of volume overload conditions in pediatric patients, such as those related to congenital heart diseases or intensive care interventions, research in this area has been markedly limited, especially when it comes to animal models that accurately represent human infants5,12,13. Utilizing piglet models can help bridge this gap, offering insight into the pediatric-specific pathophysiology of acute volume overload and the efficacy of potential therapeutic strategies7,11.
This manuscript describes a method of using a continuous infusion of crystalloid solution directly into the external jugular vein of both adult and pediatric pigs to induce acute volume overload and to study the hemodynamic effects of such volume changes on common peripheral and central data points used in volume status monitoring. This outlined method should serve as a valuable tool to help future scientists investigate the underlying pathophysiological mechanisms of acute volume overload and evaluate potential superior monitoring modalities and innovations.

<meta charset="utf8"></head><body>Yazar Spotlight: Tıpta Aşırı Hacim Yüküyle Mücadele Etmek için Domuz Modellerinde Venöz Dalga Formlarını Keşfetmek

Akut Hacim Aşırı Yüklenmesinin Yetişkin ve Pediatrik Domuz Modeli

Our team's translational research is in how vascular waveforms, specifically the low-frequency venous waveform, change in various volume and respiratory states. We are trying to understand better and improve volume status monitoring. Our research has revealed that the proper analysis of the fundamental frequency and harmonics of the pulse rate, we can sensibly monitor volume status.This novel discovery brings excitement that we may be able to achieve better volume status monitoring in a non-invasive way. Given the novel nature of our research, obtaining venous waveforms in extreme human conditions can be a big challenge. That is why porcine models such as this one are so important to what we do and what we hope to achieve.The significant finding of our research is that waveforms from the venous side, a traditionally ignored field, hold a vast amount of information, specifically the low-frequency spectrum, which is very sensitive to volume status changes. This discovery has given hope that volume monitoring in humans can be improved upon in a non-invasive way. Volume overload is a massive problem in medicine.Little research is being done on how to properly monitor against it. This protocol establishes a reproducible porcine model that can aid future scientists work to tackle this problem.

Watch this Scientific Journal Video about Author Spotlight: Exploring Venous Waveforms in Porcine Models to Tackle Volume Overload in Medicine at JoVE.com

This protocol describes an acute volume overload porcine model for adult Yorkshire pigs and piglets. Both swine ages undergo general anesthesia, ...

adult-and-pediatric-porcine-model-of-acute-volume-overload

Research

JoVE Journal

Medicine

Adult and Pediatric Porcine Model of Acute Volume Overload

339 Views.  Vanderbilt University Medical Center. Our team's translational research is in how vascular waveforms, specifically the low-frequency venous waveform, change in various volume and respiratory states. We are trying to understand better and improve volume status monitoring. Our research has revealed that the proper analysis of the fundamental frequency and harmonics of the pulse rate, we can sensibly monitor volume status.This novel discovery brings excitement that we may be able to achieve better volume status monitoring in ...