Establishing a Swine Model of Acute Respiratory Distress Syndrome Secondary to Ischemia-Reperfusion Injury Following Acute Limb Ischemia

Background: Acute Respiratory Distress Syndrome (ARDS) is a severe complication of ischemia-reperfusion injury (IRI), characterized by acute hypoxemic respiratory failure and high mortality. Acute limb ischemia (ALI) can trigger systemic inflammation leading to ARDS. This study introduces a swine m...

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Main Authors: Grzegorz Jodlowski, Rebecca Treffalls, May Dvir, Silvana N Wilken, Jonathan J Morrison, Patrick F Walker
Format: Article
Language:English
Published: Örebro University 2025-05-01
Series:Journal of Endovascular Resuscitation and Trauma Management
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Online Access:https://publicera.kb.se/jevtm/article/view/49156
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author Grzegorz Jodlowski
Rebecca Treffalls
May Dvir
Silvana N Wilken
Jonathan J Morrison
Patrick F Walker
author_facet Grzegorz Jodlowski
Rebecca Treffalls
May Dvir
Silvana N Wilken
Jonathan J Morrison
Patrick F Walker
author_sort Grzegorz Jodlowski
collection DOAJ
description Background: Acute Respiratory Distress Syndrome (ARDS) is a severe complication of ischemia-reperfusion injury (IRI), characterized by acute hypoxemic respiratory failure and high mortality. Acute limb ischemia (ALI) can trigger systemic inflammation leading to ARDS. This study introduces a swine model of ARDS secondary to ALI. Methods: Two Yorkshire swine were used in this study. Animals were anesthetized and subjected to nine hours of hindlimb ischemia via arterial occlusion. The limb was then reperfused and animals monitored through physiological parameters, computed tomography imaging, lung ultrasounds and histology. Data was then analyzed using GraphPad Prism and Analyze software for statistical and imaging evaluation. Results: Baseline measurements confirmed normal vasculature and stability, access was obtained and occlusion delivered. Following nine hours of hindlimb ischemia, reperfusion led to progressive respiratory decline, with worsening oxygenation, decline in the Horowitz index, elevated lactate and potassium levels, and imaging showing early signs of lung injury. Post-mortem analysis confirmed lung congestion, consistent with ARDS. Conclusions: The study demonstrates a novel, easily performed, cost-effective and replicable swine model of ARDS using hindlimb IRI. This model mimics physiological and sterile conditions seen in a clinical setting and serves as a valuable tool for studying ARDS. It also allows for investigation of the systemic inflammatory cascade triggered by peripheral ischemia, mirroring human ARDS cases that occur with distal injuries. Future studies with larger sample sizes and extended critical care periods are recommended to validate the technique and enhance its relevance for experimental applications.
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spelling doaj-art-c19df60c58de4ffaa150fae2331276a02025-08-20T03:09:42ZengÖrebro UniversityJournal of Endovascular Resuscitation and Trauma Management2002-75672003-539X2025-05-0110.26676/jevtm.49156Establishing a Swine Model of Acute Respiratory Distress Syndrome Secondary to Ischemia-Reperfusion Injury Following Acute Limb IschemiaGrzegorz Jodlowski0https://orcid.org/0009-0002-2993-6999Rebecca Treffalls1May Dvir2Silvana N Wilken3Jonathan J Morrison4Patrick F Walker5Department of Endovascular and Vascular Surgery, Mayo Clinic, Rochester, Minnesota, USADepartment of Endovascular and Vascular Surgery, Mayo Clinic, Rochester, Minnesota, USADepartment of Endovascular and Vascular Surgery, Mayo Clinic, Rochester, Minnesota, USADepartment of Surgery, Mayo Clinic, Rochester, Minnesota, USADepartment of Endovascular and Vascular Surgery, Mayo Clinic, Rochester, Minnesota, USADepartment of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA Background: Acute Respiratory Distress Syndrome (ARDS) is a severe complication of ischemia-reperfusion injury (IRI), characterized by acute hypoxemic respiratory failure and high mortality. Acute limb ischemia (ALI) can trigger systemic inflammation leading to ARDS. This study introduces a swine model of ARDS secondary to ALI. Methods: Two Yorkshire swine were used in this study. Animals were anesthetized and subjected to nine hours of hindlimb ischemia via arterial occlusion. The limb was then reperfused and animals monitored through physiological parameters, computed tomography imaging, lung ultrasounds and histology. Data was then analyzed using GraphPad Prism and Analyze software for statistical and imaging evaluation. Results: Baseline measurements confirmed normal vasculature and stability, access was obtained and occlusion delivered. Following nine hours of hindlimb ischemia, reperfusion led to progressive respiratory decline, with worsening oxygenation, decline in the Horowitz index, elevated lactate and potassium levels, and imaging showing early signs of lung injury. Post-mortem analysis confirmed lung congestion, consistent with ARDS. Conclusions: The study demonstrates a novel, easily performed, cost-effective and replicable swine model of ARDS using hindlimb IRI. This model mimics physiological and sterile conditions seen in a clinical setting and serves as a valuable tool for studying ARDS. It also allows for investigation of the systemic inflammatory cascade triggered by peripheral ischemia, mirroring human ARDS cases that occur with distal injuries. Future studies with larger sample sizes and extended critical care periods are recommended to validate the technique and enhance its relevance for experimental applications. https://publicera.kb.se/jevtm/article/view/49156ARDSALISwine ModelIschemia Reperfusion Injury
spellingShingle Grzegorz Jodlowski
Rebecca Treffalls
May Dvir
Silvana N Wilken
Jonathan J Morrison
Patrick F Walker
Establishing a Swine Model of Acute Respiratory Distress Syndrome Secondary to Ischemia-Reperfusion Injury Following Acute Limb Ischemia
Journal of Endovascular Resuscitation and Trauma Management
ARDS
ALI
Swine Model
Ischemia Reperfusion Injury
title Establishing a Swine Model of Acute Respiratory Distress Syndrome Secondary to Ischemia-Reperfusion Injury Following Acute Limb Ischemia
title_full Establishing a Swine Model of Acute Respiratory Distress Syndrome Secondary to Ischemia-Reperfusion Injury Following Acute Limb Ischemia
title_fullStr Establishing a Swine Model of Acute Respiratory Distress Syndrome Secondary to Ischemia-Reperfusion Injury Following Acute Limb Ischemia
title_full_unstemmed Establishing a Swine Model of Acute Respiratory Distress Syndrome Secondary to Ischemia-Reperfusion Injury Following Acute Limb Ischemia
title_short Establishing a Swine Model of Acute Respiratory Distress Syndrome Secondary to Ischemia-Reperfusion Injury Following Acute Limb Ischemia
title_sort establishing a swine model of acute respiratory distress syndrome secondary to ischemia reperfusion injury following acute limb ischemia
topic ARDS
ALI
Swine Model
Ischemia Reperfusion Injury
url https://publicera.kb.se/jevtm/article/view/49156
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