Measurement of Cerebral Metabolism Under Non-Chronic Hemodynamic Conditions.

Background: Blood flow to the brain is a critical physiological function and is useful to monitor in critical care settings. Despite that, a surrogate is most likely measured instead of actual blood flow. Such surrogates include velocity measurements in the carotid artery and systemic blood pressure, even though true blood flow can actually be obtained using MRI and other modalities.

Percutaneous left ventricular assist devices in refractory cardiac arrest: The role of chest compressions.

Background: Recent studies describe an emerging role for percutaneous left ventricular assist devices such as Impella CP® as rescue therapy for refractory cardiac arrest. We hypothesized that the addition of mechanical chest compressions to percutaneous left ventricular assist device assisted CPR would improve hemodynamics by compressing the right ventricle and augmenting pulmonary blood flow and left ventricular filling. We performed a pilot study to test this hypothesis using a swine model of prolonged cardiac arrest.

Effect of percutaneous ventricular assisted device on post-cardiac arrest myocardial dysfunction in swine model with prolonged cardiac arrest.

Background: It remains unclear if percutaneous left ventricular assist device (pLVAD) reduces post-cardiac arrest myocardial dysfunction.

Methods: This is a prespecified analysis of a subset of swine that achieved return of spontaneous circulation (ROSC) in a study comparing pLVAD, transient aortic occlusion (AO), or both during cardiopulmonary resuscitation (CPR). Devices were initiated after 24 minutes of ventricular fibrillation cardiac arrest (8 min no-flow and 16 min mechanical CPR).

Coagulofibrinolytic effects of recombinant soluble thrombomodulin in prolonged porcine cardiac arrest.

Aim: To evaluate coagulofibrinolytic abnormalities and the effects of ART-123 (recombinant human thrombomodulin alpha) in a porcine model of cardiac arrest and prolonged cardiopulmonary resuscitation (CA/CPR).

Methods: Fifteen pigs ( = 5 per group) underwent 8 minutes of no-flow CA followed by 50 minutes of mechanical CPR, while 2 pigs underwent sham arrest. CA/CPR animals were randomized to receive saline or 1 mg/kg ART-123 pre-arrest (5 minutes prior to ventricular fibrillation) or post-arrest (2 minutes after initiation of CPR).

Quality assessment of routine brain imaging at 0.55 T: initial experience in a clinical workflow.

The purpose of this study was to assess the quality of clinical brain imaging in healthy subjects and patients on an FDA-approved commercial 0.55 T MRI scanner, and to provide information about the feasibility of using this scanner in a clinical workflow. In this IRB-approved study, brain examinations on the scanner were prospectively performed in 10 healthy subjects (February-April 2022) and retrospectively derived from 44 patients (February-July 2022).

Novel prosthetic ligament repair of a shoulder luxation in a cat using a bone anchor and ligament prosthesis.

Case Summary: A 7-year-old male castrated Ragdoll cat was presented for chronic shoulder instability after a previous medial luxation of the right shoulder. Upon examination, there was palpable instability of the glenohumeral joint and an increased abduction angle. Surgical stabilisation was elected due to lameness and instability after closed reduction, rest and medical management.

Haemodynamic impact of aortic balloon occlusion combined with percutaneous left ventricular assist device during cardiopulmonary resuscitation in a swine model of cardiac arrest.

Aim: To investigate the effect of tandem use of transient balloon occlusion of the descending aorta (AO) and percutaneous left ventricular assist device (pl-VAD) during cardiopulmonary resuscitation in a large animal model of prolonged cardiac arrest.

Methods: Ventricular fibrillation was induced and left untreated for 8 minutes followed by 16 minutes of mechanical CPR (mCPR) in 24 swine, under general anesthesia. Animals were randomized to 3 treatment groups (n = 8 per group): A) pL-VAD (Impella CP®) B) pL-VAD+AO, and C) AO.

Therapeutic Effect of Argatroban During Cardiopulmonary Resuscitation and Streptokinase During Extracorporeal Cardiopulmonary Resuscitation in a Porcine Model of Prolonged Cardiac Arrest.

Unlabelled: Prolonged cardiac arrest (CA) causes microvascular thrombosis which is a potential barrier to organ reperfusion during extracorporeal cardiopulmonary resuscitation (ECPR). The aim of this study was to test the hypothesis that early intra-arrest anticoagulation during cardiopulmonary resuscitation (CPR) and thrombolytic therapy during ECPR improve recovery of brain and heart function in a porcine model of prolonged out-of-hospital CA.

Design: Randomized interventional trial.

Novel use of riboflavin as a fluorescent tracer in the dissemination of aerosol and splatter in an open operatory dental clinic.

Objectives: The rapid spread of severe acute respiratory syndrome coronavirus 2 and the ensuing rise of the COVID-19 pandemic have impacted healthcare unprecedentedly. With the scarcity of available resources, including healthcare providers themselves, novel methods for tracking aerosol and splatter in real time are required to alleviate demand and increase safety. This study evaluates the utility of riboflavin (vitamin B ) as a tracer for splatter/aerosol distribution from ultrasonic scaling in an open operatory clinic.

Tandem use of gastroesophageal resuscitative occlusion of the aorta followed by resuscitative endovascular balloon occlusion of the aorta in a lethal liver laceration model.

Background: Gastroesophageal resuscitative occlusion of the aorta (GROA) has been shown effective in creating zone II aortic occlusion capable of temporarily improving survival in animal models of lethal noncompressible torso hemorrhage. In this study, tandem application of GROA transitioning to resuscitative endovascular balloon occlusion of the aorta (REBOA) is explored to demonstrate feasibility as a potential point-of-injury bridge to more advanced care, using a swine model of lethal abdominal hemorrhage.

Methods: Swine (n = 19) were anesthetized, instrumented, and subjected to a combination of controlled and uncontrolled hemorrhage from a grade-V liver laceration.

Redox Potential Correlates with Changes in Metabolite Concentrations Attributable to Pathways Active in Oxidative Stress Response in Swine Traumatic Shock.

Introduction: Oxidation-reduction (redox) reactions, and the redox potential (RP) that must be maintained for proper cell function, lie at the heart of physiologic processes in critical illness. Imbalance in RP reflects systemic oxidative stress, and whole blood RP measures have been shown to correlate with oxygen debt level over time in swine traumatic shock. We hypothesize that RP measures reflect changing concentrations of metabolites involved in oxidative stress.

Breath analysis for detection and trajectory monitoring of acute respiratory distress syndrome in swine.

Despite the enormous impact on human health, acute respiratory distress syndrome (ARDS) is poorly defined, and its timely diagnosis is difficult, as is tracking the course of the syndrome. The objective of this pilot study was to explore the utility of breath collection and analysis methodologies to detect ARDS through changes in the volatile organic compound (VOC) profiles present in breath. Five male Yorkshire mix swine were studied and ARDS was induced using both direct and indirect lung injury.

Tracking Peripheral Artery Motion and Vascular Resistance With a Multimodal Wearable Sensor Under Pressure Perturbations.

The status of peripheral arteries is known to be a key physiological indicator of the body's response to both acute and chronic medical conditions. In this paper, peripheral artery deformation is tracked by wearable photoplethysmograph (PPG) and piezo-electric (polyvinylidene difluoride, PVDF) sensors, under pressure-varying cuff. A simple mechanical model for the local artery and intervening tissue captures broad features present in the PPG and PVDF signals on multiple swine subjects, with respect to varying cuff pressure.

Gastroesophageal resuscitative occlusion of the aorta prolongs survival in a lethal liver laceration model.

Background: Noncompressible torso hemorrhage management remains a challenge especially in the prehospital setting. We evaluated a device designed to occlude the aorta from the stomach (gastroesophageal resuscitative occlusion of the aorta [GROA]) for its ability to stop hemorrhage and improve survival in a swine model of lethal liver laceration and compared its performance to resuscitative endovascular balloon occlusion of the aorta (REBOA) and controls.

Methods: Swine (n = 24) were surgically instrumented and a 30% controlled arterial hemorrhage over 20 minutes was followed by liver laceration.

Nicotine-related misperceptions among faculty and students at a Midwestern dental school.

Purpose/objectives: To determine the perceptions about the ill-effects of nicotine in students and faculty at a Midwestern dental school. This information will help inform the school and improve teaching on this subject during a time when electronic nicotine delivery systems are increasingly popular.

Methods: An online survey of dental students and faculty of a Midwestern dental school was deployed in November, 2020 to determine their level of misperception about the ill effects of nicotine.

Detection of Low Cardiac Index using a Polyvinylidene Fluoride-Based Wearable Ring and Convolutional Neural Networks.

This study investigated the use of a wearable ring made of polyvinylidene fluoride film to identify a low cardiac index (≤2 L/min). The waveform generated by the ring contains patterns that may be indicative of low blood pressure and/or high vascular resistance, both of which are markers of a low cardiac index. In particular, the waveform contains reflection waves whose timing and amplitude are correlated with pulse travel time and vascular resistance, respectively.

Trans-Ocular Brain Impedance Indices Predict Pressure Reactivity Index Changes in a Porcine Model of Hypotension and Cerebral Autoregulation Perturbation.

Background: Cerebrovascular autoregulation (CA) is a protective mechanism that enables the cerebral vasculature to automodulate tone in response to changes in cerebral perfusion pressure to ensure constant levels of cerebral blood flow (CBF) and oxygen delivery. CA can be impaired after neurological injury and contributes to secondary brain injury. In this study, we report novel impedance indices using trans-ocular brain impedance (TOBI) during controlled systemic hemorrhage and hypotension to assess CA in comparison with pressure reactivity index (PRx).

Dose optimization of early high-dose valproic acid for neuroprotection in a swine cardiac arrest model.

Aim: High-dose valproic acid (VPA) improves the survival and neurologic outcomes after asphyxial cardiac arrest (CA) in rats. We characterized the pharmacokinetics, pharmacodynamics, and safety of high-dose VPA in a swine CA model to advance clinical translation.

Methods: After 8 ​min of untreated ventricular fibrillation CA, 20 male Yorkshire swine were resuscitated until return of spontaneous circulation (ROSC).

A novel swine model of the acute respiratory distress syndrome using clinically relevant injury exposures.

To date, existing animal models of the acute respiratory distress syndrome (ARDS) have failed to translate preclinical discoveries into effective pharmacotherapy or diagnostic biomarkers. To address this translational gap, we developed a high-fidelity swine model of ARDS utilizing clinically relevant lung injury exposures. Fourteen male swine were anesthetized, mechanically ventilated, and surgically instrumented for hemodynamic monitoring, blood, and tissue sampling.

An activated-zinc oral rinse reduces pro-inflammatory cytokine secretion and promotes proliferation in Porphyromonas gingivalis LPS-challenged gingival tissues - A pilot study.

Objectives: The use of adjunct post-treatment mouth rinses containing chlorhexidine (CHX) for periodontitis patients is associated with side effects that reduce patient compliance. Our aim was to evaluate the proinflammatory and cell proliferation effects of an activated-zinc mouth rinse (SM) that has been suggested as an alternative post-treatment therapeutic.

Materials And Methods: Tissue models of gingival epithelium were used to simulate periodontal disease and compare inflammatory reactions after treatment with CHX or SM.

Few-Layer MoS Photodetector Arrays for Ultrasensitive On-Chip Enzymatic Colorimetric Analysis.

Enzymatic colorimetric analysis of metabolites provides signatures of energy conversion and biosynthesis associated with disease onsets and progressions. Miniaturized photodetectors based on emerging two-dimensional transition metal dichalcogenides (TMDCs) promise to advance point-of-care diagnosis employing highly sensitive enzymatic colorimetric detection. Reducing diagnosis costs requires a batched multisample assay.

Novel intraperitoneal hemostasis device prolongs survival in a swine model of noncompressible abdominal hemorrhage.

Background: Noncompressible torso hemorrhage (NCTH) of the abdomen is a challenge to rapidly control and treat in the prehospital and emergency department settings. In this pilot study, we developed a novel intraperitoneal hemostasis device (IPHD) prototype and evaluated its ability for slowing NCTH and prolonging survival in a porcine model of lethal abdominal multiorgan hemorrhage.

Methods: Yorkshire male swine (N = 8) were instrumented under general anesthesia for monitoring of hemodynamics and blood sampling.