improving rodent cardiovascular research outcomes with integrated surgical monitoring
TRANSCRIPT
Improving Rodent Cardiovascular Research Outcomes with Integrated Surgical Monitoring
1. Attaining ‘Normal’ Cardiac Function for PV Analysis (Dr. James Clark)
• Parameters to Monitor & How
• The importance of Fluid-Support
• Effects of Anaesthesia and Cooling
• How Temperature can Effect Infarct Size
2. Demonstration: Integrated Monitoring with the MouseMonitor™ S (Graham Sattler)
• System Operation, File Recording and Playback
• Screenshots for Collaboration
• System Integration Components and Configuration
• Presets and Flexibility
Sponsored by:
InsideScientific is an online educational environment designed for life science researchers. Our goal is to aid in
the sharing and distribution of scientific information regarding innovative technologies, protocols, research
tools and laboratory services.
Attaining ‘Normal’ Cardiac Function For PV Analysis
Dr. James E. Clark Senior Lecturer in Applied Physiology
British Heart Foundation Centre of Excellence, Cardiovascular Division,
Faculty of Life Sciences and Medicine, King’s College London
0 10 20 30 40 50
0
20
40
60
80
100
120
Volume (µl)
LV
Pre
ss
ure
(m
mH
g)
Complicated Surgery occupies the surgeon
Myocardial infarction Abdominal aortic
banding PV Loop acquisition
Myocardial infarction Abdominal aortic
banding PV Loop acquisition
Complicated Surgery occupies the surgeon
EFFECTIVE MONITORING IS KEY!
Parameters to Monitor
• Temperature
• ECG
• Respiration
• Oxygen Saturation
• Blood Pressure
• Respiratory Gasses (ETO2 and ETCO2)
• Blood Flow (peripheral)
ESSENTIA
L D
ESIRA
BLE
OP
TION
AL
• Operating table and microscope
• Homeothermic platform
• Physiological Monitoring
• PV Catheter and data acquisition system
• Suitable anaesthetic
• Ventilation
• Surgical instruments
Essentials for Murine PV Surgery
• Maintain ‘normal blood volume’ during any measurement
– Proper hydration
– Fluid support
• Fluid support can be administered I.V. or I.P.
– Saline
– 1-3% BSA
– Hydroxyethyl starch
• Care should be taken not to over-hydrate
From Zuurbier et al, AJP (282), 2002
The Importance of Fluid Support
Haes (0.2ml/10g/hr)
Saline (0.5ml/10g/hr)
0 10 20 30 0
20
40
60
80
100
Volume (µl)
Pre
ssure
(m
m H
g)
Abdominal IVC occlusion
Fluid Support Maintains Blood Pressure
Resulting PV Loop measures
Yang X et al. Am J Physiol Heart Circ Physiol 1999;277:H1967-H1974
K e t /M e d 2 % IS O 2 % IS O
0
2 0 0
4 0 0
6 0 0
0
5 0
1 0 0
1 5 0
HR
(b
pm
)
EF
(%) &
SP
(mm
Hg
)
HR E F % S P (m m H g )
In tu b a te d
*
*
*
**
Clark et al. (unpublished data)
Anaesthetics and Cardiac Function
Picard et al, F1000Research (3), 2014
Effect of the Depth of Anaesthesia
There are considerable differences between INDUCTION and MAINTENANCE-levels of anaesthesia on function.
Even small changes in temperature can effect function
Pre
ssu
re (
mm
hg)
0
20
40
60
80
100
Baseline Cooling Re-warmed
Clark et al. (unpublished data)
Affect of Cooling on Developed Pressure
Baseline Heater Turned Off (7.5 minutes) Re-warmed (200 ul 42°C saline I.P.)
Temperature Monitoring DURING Procedures P
ress
ure
(m
mh
g)
0
20
40
60
80
Unless homeostasis is maintained data will ‘drift’
Clark et al. (unpublished data)
20 25 30 35 40
0
50
100
150
Core Temperature (°C)
Syst
olic
Pre
ssu
re (
mm
Hg
)
20 25 30 35 40
0
10
20
30
40
Core Temperature (°C)
Str
oke
Vo
lum
e (µ
l)
The Importance of Temperature Monitoring
C57bl/6j mice subjected to cooling/re-warming protocol Clark et al. (unpublished data)
(N=5) (N=5)
0
25
50
75
100 37˚C 32˚C 24˚C 20˚C
RVU
LV
Pre
ssu
re (
mm
Hg)
Clark et al. (unpublished data)
Core Temperature
The Importance of Temperature Monitoring
Apical PV Access 0 200 400 600 800
32
34
36
38
40
500
550
600
650
Time (sec)
Core
Tem
pera
ture
(°C
)
HR
(bpm
)
Temp
HR
Thoracotomy
39-40°C saline-soaked gauze to avoid evaporative heat loss
Clark et al. (unpublished data)
Maintenance of temperature throughout protocol
Clark & Marber Exp.Physiol. (2013)
Murine Myocardial Ischaemia-Reperfusion
Suture snare system
Clark et al. Journal of Pharmacological and Toxicological Methods, Vol. 59, No. 2, 03.2009, p. 94 - 99.
Murine Myocardial Ischaemia-Reperfusion
Hanging weight system
Murine Myocardial Ischaemia-Reperfusion
Balloon in place
Balloon inflated
Clark & Marber Exp.Physiol. (2013)
Eckle et al. Am J Physiol Heart Circ Physiol 291: H2533–H2540, 2006
Infarct size is dependent on temperature
Sutherland et al. Clin and Exp. Pharmacol. and Physiol. (2003) 30, 867–878
Tissier R et al. Cardiovasc Res. (2012) 94(2):217-25
Infarct size is dependent on temperature
Cardiac temperature (°C) during a 30 min CAO in rabbits Cardiac temperature (°C) during a 60 min CAO in sheep
• ECG -- limb lead and augmented leads
• HR
• Breathing rate
• Core temperature
• Blood oxygenation (with SpO2 module)
• Data recording
– On tablet and/or
– Analogue output
MouseMonitor™ S
Preliminary Results
Stable monitoring platform
No electrical interference with PV acquisition
Reliable ECG and data recording using built-in pads or needle electrodes
Temperature control 0 10 20 30 40 50
0
20
40
60
80
100
120
Volume (µl)
LV
Pre
ss
ure
(m
mH
g)
A Demonstration: Integrated Surgical Monitoring with the MouseMonitor™ S
Graham Sattler
Product Development Manager,
Indus Instruments
1. PV Loop Theory
2. PV Loop Applications
3. PV Loop System Setup Tips & Best Practices
4. PV Loop Surgical Preparation Overview
5. PV Loop Signal Optimization Tips & Best Practices
6. PV Loop Procedure Documentation
PV Loop Webinar Series so far…
1. PV Loop Theory
2. PV Loop Applications
3. PV Loop System Setup Tips & Best Practices
4. PV Loop Surgical Preparation Overview
5. PV Loop Signal Optimization Tips & Best Practices
6. PV Loop Procedure Documentation
7. Surgical Procedure Outcome Evaluation
PV Loop Webinar Series so far…
Capability
• Responsive Heating
• Surgical Monitoring
– Heart Rate
– Core Temperature
– ECG (6-Lead)
– Mouse & Rat Electrodes
• Easy Documentation
View the following demonstration videos online…
1. System Operation
2. Standalone File Recording & Playback
3. Capturing Screenshots for Collaboration
View the following demonstration videos online…
1. System Integration
Configuration
2. Presets & Flexibility
Thank You! For additional information on Surgical Monitoring best-practices and solutions for preclinical research please visit:
http://www.indusinstruments.com
NEXT WEBINAR: Dr. Navin Kapur, Assistant Professor and Assistant Director of the MCRI at Tufts, will discuss how PV loop data can translate from mouse to man and provide a confident approach to evaluating drug studies, device validation and treatments outcomes.
WORKSHOP: