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Nordström CH, Forsse A, Jakobsen RP, Mölström S, Nielsen TH, Toft P, Ungerstedt U. Bedside interpretation of cerebral energy metabolism utilizing microdialysis in neurosurgical and general intensive care. Front Neurol 2022; 13:968288. [PMID: 36034291 PMCID: PMC9399721 DOI: 10.3389/fneur.2022.968288] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 07/11/2022] [Indexed: 12/02/2022] Open
Abstract
The microdialysis technique was initially developed for monitoring neurotransmitters in animals. In 1995 the technique was adopted to clinical use and bedside enzymatic analysis of glucose, pyruvate, lactate, glutamate and glycerol. Under clinical conditions microdialysis has also been used for studying cytokines, protein biomarkers, multiplex proteomic and metabolomic analyses as well as for pharmacokinetic studies and evaluation of blood-brain barrier function. This review focuses on the variables directly related to cerebral energy metabolism and the possibilities and limitations of microdialysis during routine neurosurgical and general intensive care. Our knowledge of cerebral energy metabolism is to a large extent based on animal experiments performed more than 40 years ago. However, the different biochemical information obtained from various techniques should be recognized. The basic animal studies analyzed brain tissue homogenates while the microdialysis technique reflects the variables in a narrow zone of interstitial fluid surrounding the probe. Besides the difference of the volume investigated, the levels of the biochemical variables differ in different compartments. During bedside microdialysis cerebral energy metabolism is primarily reflected in measured levels of glucose, lactate and pyruvate and the lactate to pyruvate (LP) ratio. The LP ratio reflects cytoplasmatic redox-state which increases instantaneously during insufficient aerobic energy metabolism. Cerebral ischemia is characterized by a marked increase in intracerebral LP ratio at simultaneous decreases in intracerebral levels of pyruvate and glucose. Mitochondrial dysfunction is characterized by a moderate increase in LP ratio at a very marked increase in cerebral lactate and normal or elevated levels of pyruvate and glucose. The patterns are of importance in particular for interpretations in transient cerebral ischemia. A new technique for evaluating global cerebral energy metabolism by microdialysis of the draining cerebral venous blood is discussed. In experimental studies it has been shown that pronounced global cerebral ischemia is reflected in venous cerebral blood. Jugular bulb microdialysis has been investigated in patients suffering from subarachnoid hemorrhage, during cardiopulmonary bypass and resuscitation after out of hospital cardiac arrest. Preliminary results indicate that the new technique may give valuable information of cerebral energy metabolism in clinical conditions when insertion of an intracerebral catheter is contraindicated.
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Affiliation(s)
- Carl-Henrik Nordström
- Department of Neurosurgery, Odense University Hospital, Odense, Denmark
- *Correspondence: Carl-Henrik Nordström
| | - Axel Forsse
- Department of Neurosurgery, Rigshospitalet, Copenhagen, Denmark
| | - Rasmus Peter Jakobsen
- Department of Anesthesiology and Intensive Care, Odense University Hospital, Odense, Denmark
| | - Simon Mölström
- Department of Anesthesiology and Intensive Care, Odense University Hospital, Odense, Denmark
| | | | - Palle Toft
- Department of Anesthesiology and Intensive Care, Odense University Hospital, Odense, Denmark
| | - Urban Ungerstedt
- Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden
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2
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Góes AMDO, Chaves RHDF, Furlaneto IP, Rodrigues EDM, de Albuquerque FBA, Smit JHA, de Oliveira CP, Abib SDCV. Comparative angiotomographic study of swine vascular anatomy: contributions to research and training models in vascular and endovascular surgery. J Vasc Bras 2021; 20:e20200086. [PMID: 34093675 PMCID: PMC8147709 DOI: 10.1590/1677-5449.200086] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Medium and large animal models allow researchers to evaluate the efficacy and safety of cardiovascular procedures in systems that resemble human anatomy and can be used to simulate scenarios for training purposes. Although porcine models have been used extensively, many physiological and anatomical features remain unknown or only superficially described. Objectives To describe the normal porcine vascular anatomy on computed tomography scans, compare it to human vascular anatomy, and discuss the application of porcine models for open and endovascular procedures. Methods Three male Landrace pigs underwent computed tomography. The vascular anatomy of the neck, thorax, abdomen, and limbs was analyzed and described; relevant similarities and differences between porcine and human vascular anatomies and the implications for vascular procedures in pigs are highlighted. Results The carotid territory, aortic arch, and terminal aorta branches all show marked differences in pigs compared to their human counterparts. Compressions of both left renal and common iliac veins were detected, analogous to those seen in human Nutcracker and May-Thurner syndromes. Vascular measurements (diameters, lengths, and angles) of several different porcine territories are presented. Conclusions The data presented should be useful for planning preclinical trials and basic research and for refining surgical training using porcine models in vascular fields.
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Affiliation(s)
- Adenauer Marinho de Oliveira Góes
- Centro Universitário do Estado do Pará - CESUPA, Curso de Medicina, Belém, PA, Brasil.,Universidade Federal de São Paulo - UNIFESP, Programa de Ciência Cirúrgica Interdisciplinar, São Paulo, SP, Brasil
| | | | | | | | | | | | | | - Simone de Campos Vieira Abib
- Universidade Federal de São Paulo - UNIFESP, Programa de Ciência Cirúrgica Interdisciplinar, São Paulo, SP, Brasil
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3
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Norris C, Lisinski J, McNeil E, VanMeter JW, VandeVord P, LaConte SM. MRI brain templates of the male Yucatan minipig. Neuroimage 2021; 235:118015. [PMID: 33798725 DOI: 10.1016/j.neuroimage.2021.118015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 03/14/2021] [Accepted: 03/17/2021] [Indexed: 10/21/2022] Open
Abstract
The pig is growing in popularity as an experimental animal because its gyrencephalic brain is similar to humans. Currently, however, there is a lack of appropriate brain templates to support functional and structural neuroimaging pipelines. The primary contribution of this work is an average volume from an iterative, non-linear registration of 70 five- to seven-month-old male Yucatan minipigs. In addition, several aspects of this study are unique, including the comparison of linear and non-linear template generation, the characterization of a large and homogeneous cohort, an analysis of effective resolution after averaging, and the evaluation of potential in-template bias as well as a comparison with a template from another minipig species using a "left-out" validation set. We found that within our highly homogeneous cohort, non-linear registration produced better templates, but only marginally so. Although our T1-weighted data were resolution limited, we preserved effective resolution across the multi-subject average, produced templates that have high gray-white matter contrast and demonstrate superior registration accuracy compared to an alternative minipig template.
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Affiliation(s)
- Carly Norris
- Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA, United States
| | - Jonathan Lisinski
- Fralin Biomedical Research Institute, Virginia Tech, Roanoke, VA, United States
| | - Elizabeth McNeil
- Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA, United States
| | - John W VanMeter
- Neurology, Georgetown University, Washington, DC, United States
| | - Pamela VandeVord
- Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA, United States; Salem VA Medical Center, Salem VA, United States
| | - Stephen M LaConte
- Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA, United States; Fralin Biomedical Research Institute, Virginia Tech, Roanoke, VA, United States.
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4
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"Reply to: Cerebral venous blood is not drained via the internal jugular vein in the pig". Resuscitation 2021; 162:439-440. [PMID: 33592231 DOI: 10.1016/j.resuscitation.2021.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 02/02/2021] [Indexed: 11/20/2022]
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5
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Nordström CH, Jakobsen R, Mølstrøm S, Nielsen TH. Cerebral venous blood is not drained via the internal jugular vein in the pig. Resuscitation 2021; 162:437-438. [PMID: 33582253 DOI: 10.1016/j.resuscitation.2021.01.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 01/04/2021] [Indexed: 10/22/2022]
Affiliation(s)
| | - Rasmus Jakobsen
- Department of Anesthesia and Intensive Care, Odense University Hospital, Denmark
| | - Simon Mølstrøm
- Department of Anesthesia and Intensive Care, Odense University Hospital, Odense C, Denmark
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6
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Walsh DR, Lynch JJ, O' Connor DT, Newport DT, Mulvihill JJE. Mechanical and structural characterisation of the dural venous sinuses. Sci Rep 2020; 10:21763. [PMID: 33303894 PMCID: PMC7729903 DOI: 10.1038/s41598-020-78694-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 11/26/2020] [Indexed: 12/27/2022] Open
Abstract
The dural venous sinuses play an integral role in draining venous blood from the cranial cavity. As a result of the sinuses anatomical location, they are of significant importance when evaluating the mechanopathology of traumatic brain injury (TBI). Despite the importance of the dural venous sinuses in normal neurophysiology, no mechanical analyses have been conducted on the tissues. In this study, we conduct mechanical and structural analysis on porcine dural venous sinus tissue to help elucidate the tissues’ function in healthy and diseased conditions. With longitudinal elastic moduli values ranging from 33 to 58 MPa, we demonstrate that the sinuses exhibit higher mechanical stiffness than that of native dural tissue, which may be of interest to the field of TBI modelling. Furthermore, by employing histological staining and a colour deconvolution protocol, we show that the sinuses have a collagen-dominant extracellular matrix, with collagen area fractions ranging from 84 to 94%, which likely explains the tissue’s large mechanical stiffness. In summary, we provide the first investigation of the dural venous sinus mechanical behaviour with accompanying structural analysis, which may aid in understanding TBI mechanopathology.
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Affiliation(s)
- Darragh R Walsh
- Bernal Institute, University of Limerick, Limerick, Ireland.,School of Engineering, University of Limerick, Limerick, Ireland
| | - James J Lynch
- Bernal Institute, University of Limerick, Limerick, Ireland.,School of Engineering, University of Limerick, Limerick, Ireland
| | - David T O' Connor
- Bernal Institute, University of Limerick, Limerick, Ireland.,School of Engineering, University of Limerick, Limerick, Ireland.,Health Research Institute, University of Limerick, Limerick, Ireland
| | - David T Newport
- Bernal Institute, University of Limerick, Limerick, Ireland.,School of Engineering, University of Limerick, Limerick, Ireland
| | - John J E Mulvihill
- Bernal Institute, University of Limerick, Limerick, Ireland. .,School of Engineering, University of Limerick, Limerick, Ireland. .,Health Research Institute, University of Limerick, Limerick, Ireland.
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7
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Rescue oxygenation success by cannula or scalpel-bougie emergency front-of-neck access in an anaesthetised porcine model. PLoS One 2020; 15:e0232510. [PMID: 32365136 PMCID: PMC7197851 DOI: 10.1371/journal.pone.0232510] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 04/16/2020] [Indexed: 11/19/2022] Open
Abstract
In the obese, the evidence for the choice of the optimal emergency front-of-neck access technique is very limited and conflicting. We compared cannula and scalpel-bougie emergency front-of-neck access techniques in an anaesthetised porcine model with thick pretracheal tissue. Cannula and scalpel-bougie cricothyroidotomy techniques were performed in 11 and 12 anaesthetised pigs, respectively. Following successful tracheal access, oxygenation was commenced and continued for 5 min using Rapid-O2 device for cannula and circle breathing system for scalpel-bougie study groups. The primary outcome was a successful rescue oxygenation determined by maintenance of arterial oxygen saturation >90% 5 min after the beginning of oxygenation. Secondary outcomes included success rate of airway device placement, time to successful airway device placement, and trauma to the neck and airway. The success rate of rescue oxygenation was 18% after cannula, and 83% after scalpel-bougie technique (P = 0.003). The success rate of airway device placement was 73% with cannula and 92% with scalpel-bougie technique (P = 0.317). Median (inter-quartile-range) times to successful airway device placement were 108 (30–256) and 90 (63–188) seconds (P = 0.762) for cannula and scalpel-bougie emergency front-of-neck access, respectively. Proportion of animals with iatrogenic trauma additional to the procedure itself was 27% for cannula and 75% for scalpel-bougie technique (P = 0.039). Thus, in the porcine model of obesity, the scalpel-bougie technique was more successful in establishing and maintaining rescue oxygenation than cannula-based technique; however, it was associated with a higher risk of severe trauma.
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8
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Kinder HA, Baker EW, West FD. The pig as a preclinical traumatic brain injury model: current models, functional outcome measures, and translational detection strategies. Neural Regen Res 2019; 14:413-424. [PMID: 30539807 PMCID: PMC6334610 DOI: 10.4103/1673-5374.245334] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Traumatic brain injury (TBI) is a major contributor of long-term disability and a leading cause of death worldwide. A series of secondary injury cascades can contribute to cell death, tissue loss, and ultimately to the development of functional impairments. However, there are currently no effective therapeutic interventions that improve brain outcomes following TBI. As a result, a number of experimental TBI models have been developed to recapitulate TBI injury mechanisms and to test the efficacy of potential therapeutics. The pig model has recently come to the forefront as the pig brain is closer in size, structure, and composition to the human brain compared to traditional rodent models, making it an ideal large animal model to study TBI pathophysiology and functional outcomes. This review will focus on the shared characteristics between humans and pigs that make them ideal for modeling TBI and will review the three most common pig TBI models-the diffuse axonal injury, the controlled cortical impact, and the fluid percussion models. It will also review current advances in functional outcome assessment measures and other non-invasive, translational TBI detection and measurement tools like biomarker analysis and magnetic resonance imaging. The use of pigs as TBI models and the continued development and improvement of translational assessment modalities have made significant contributions to unraveling the complex cascade of TBI sequela and provide an important means to study potential clinically relevant therapeutic interventions.
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Affiliation(s)
- Holly A Kinder
- Regenerative Bioscience Center; Department of Animal and Dairy Science, University of Georgia, Athens, GA, USA
| | - Emily W Baker
- Regenerative Bioscience Center; Department of Animal and Dairy Science, University of Georgia, Athens, GA, USA
| | - Franklin D West
- Regenerative Bioscience Center; Department of Animal and Dairy Science, University of Georgia, Athens, GA, USA
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9
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Mokrane FZ, Dercle L, Meyrignac O, Crubézy É, Rousseau H, Telmon N, Dedouit F. Towards multi-phase postmortem CT angiography in children: a study on a porcine model. Int J Legal Med 2018; 132:1391-1403. [PMID: 29380125 DOI: 10.1007/s00414-018-1783-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 01/16/2018] [Indexed: 10/18/2022]
Abstract
PURPOSE Multi-phase postmortem computed tomography angiography (MPMCTA) is a growing technique, which is standardized for adults. Application of this protocol for a children population is not so well defined. Our study aims to adapt the adult's protocol to children, using a porcine model. MATERIAL AND METHODS Three groups of 18 pigs were studied, with a weight distribution between 4 and 48 kg. Different pump devices were used. Pigs of group I were studied using the Virtangio® machine, whereas pigs of groups II and III were studied using used the Medrad® machine. Study of vascular opacification was possible using a semi-quantitative method based on 26 arterial and 26 venous segments that were distributed over the entire body from the cephalic extremity to the posterior pawns. RESULTS While thoracic, abdominal, and pelvic vascular opacification were complete for each individual pig in a group, group III showed better vascular opacification for the cephalic extremity. This was also true for anterior and posterior pawns vascular opacification. Spearman correlation tests showed a significant relationship between anthropometric characteristics of pigs, injection parameters, and percentage of opacified segments. A higher percentage of opacification was obtained for individuals of lower weights, with comparatively lower quantities of contrast agent injected. CONCLUSION Postmortem computed tomography angiography (PMCTA) was possible for all the individuals, particularly for small weights (4 kg) using the Medrad® machine. However, further studies are needed to better understand the procedure.
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Affiliation(s)
- F Z Mokrane
- Radiology Department, Rangueil University Hospital, 1 Avenue du Professeur Jean Poulhes, 31059 cedex, Toulouse, France. .,French National Center for Scientific Research, AMIS Laboratory: University of Toulouse, UMR 5288, 37 allées Jules Guesde, 31073, Toulouse, France.
| | - L Dercle
- Gustave Roussy Institute, Université Paris-Saclay, F-94805, Villejuif, France.,New York Presbyterian Hospital, Columbia University, New York, NY, 10039, USA
| | - O Meyrignac
- Radiology Department, Rangueil University Hospital, 1 Avenue du Professeur Jean Poulhes, 31059 cedex, Toulouse, France
| | - É Crubézy
- French National Center for Scientific Research, AMIS Laboratory: University of Toulouse, UMR 5288, 37 allées Jules Guesde, 31073, Toulouse, France
| | - H Rousseau
- Radiology Department, Rangueil University Hospital, 1 Avenue du Professeur Jean Poulhes, 31059 cedex, Toulouse, France
| | - N Telmon
- French National Center for Scientific Research, AMIS Laboratory: University of Toulouse, UMR 5288, 37 allées Jules Guesde, 31073, Toulouse, France.,Forensic Department, Rangueil University Hospital, 1 avenue du Professeur Jean Poulhes. 31059 cedex, Toulouse, France
| | - F Dedouit
- French National Center for Scientific Research, AMIS Laboratory: University of Toulouse, UMR 5288, 37 allées Jules Guesde, 31073, Toulouse, France.,Unit of Forensic and Anthropological Imaging, Centre universitaire romand de médecine légale (CURML), Chemin de la Vulliette 4, CH-1000, Lausanne 25, Switzerland
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10
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Ong CS, Fukunishi T, Liu RH, Nelson K, Zhang H, Wieczorek E, Palmieri M, Ueyama Y, Ferris E, Geist GE, Youngblood B, Johnson J, Hibino N. Bilateral Arteriovenous Shunts as a Method for Evaluating Tissue-Engineered Vascular Grafts in Large Animal Models. Tissue Eng Part C Methods 2017; 23:728-735. [PMID: 28741438 DOI: 10.1089/ten.tec.2017.0217] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
There remains a need for large animal models to evaluate tissue-engineered vascular grafts (TEVGs) under arterial pressure to provide preclinical data for future potential human clinical trials. We present a comprehensive method for the interrogation of TEVGs, using an ovine bilateral arteriovenous (AV) shunt implantation model. Our results demonstrate that this method can be performed safely without complications, specifically acute heart failure, steal syndrome, and hypoxic brain injury, and it is a viable experimental paradigm. Our method allows for a non-invasive evaluation of TEVGs in terms of graft flow, graft diameter, and graft patency, while also allowing for graft needle puncture under ultrasound guidance. In addition, traditional pathological analysis, histology, and immunohistochemistry may be performed with the contralateral side providing paired control data to eliminate inter-subject variability while reducing the total number of animals. Further, we present a review of existing literature of preclinical evaluation of TEVGs in large animal models as AV conduits.
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Affiliation(s)
- Chin Siang Ong
- 1 Division of Cardiac Surgery, John Hopkins Hospital , Baltimore, Maryland
| | - Takuma Fukunishi
- 1 Division of Cardiac Surgery, John Hopkins Hospital , Baltimore, Maryland
| | - Rui Han Liu
- 1 Division of Cardiac Surgery, John Hopkins Hospital , Baltimore, Maryland
| | | | - Huaitao Zhang
- 1 Division of Cardiac Surgery, John Hopkins Hospital , Baltimore, Maryland
| | | | | | | | | | | | | | - Jed Johnson
- 2 Nanofiber Solutions, Inc. , Hilliard, Ohio
| | - Narutoshi Hibino
- 1 Division of Cardiac Surgery, John Hopkins Hospital , Baltimore, Maryland
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