Acute Kidney Injury (AKI) is a common, highly lethal, complication of critical illness which has a high mortality [1][2][3][4] and which is most frequently caused by whole-body hypoperfusion. 5,6 Successful reproduction of whole-body hypoperfusion in rodent models has been fraught with difficulty. 7-9,9,10 Models which employ focal ischemia have repeatedly demonstrated results which do not translate to the clinical setting, and larger animal models which allow for whole body hypoperfusion lack access to the full toolset of genetic manipulation possible in the mouse. 11,12 However, in recent years a mouse model of cardiac arrest and cardiopulmonary resuscitation has emerged which can be adapted to model AKI. 13 This model reliably reproduces physiologic, functional, anatomic, and histologic outcomes seen in clinical AKI, is rapidly repeatable, and offers all of the significant advantages of a murine surgical model, including access to genetic manipulative techniques, low cost relative to large animals, and ease of use. Our group has developed extensive experience with use of this model to assess a number of organ-specific outcomes in AKI. 14,15
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ProtocolAll procedures described are conducted in accordance with the National Institutes of Health guidelines for the care and use of animals in research and all animal protocols were approved by the Oregon Health & Science University Institutional Animal Care and Use Committee. Weigh the mouse. The procedure described is performed on C57BL/6 mice weighing between 20 and 25 g. Anesthesia is induced in an induction box using 3-4% isoflurane, and subsequently maintained using 1.5-2.5% isoflurane in air/oxygen mixture. 2. Lubricate the eyes and position the animal supine on a heating pad. Immobilize 4 extremities using tape. The hind-paws may be taped in a neutral position, however, the forepaws should be secured as near to the chest wall as possible to allow full chest wall excursion during chest compressions. 3. Lubricate and place a rectal temperature probe. Temperature is controlled using a heating pad and lamp connected to an electronic temperature controller (Digi-Sense, Cole Parmer, Vernon Hills IL), which is set to maintain 37.0°C. Because it is possible that a temperature gradient within the animal could develop during the no-flow state, it is important that temperature be measured and controlled near the organ of interest. 4. Intubate the trachea using a 2.5 cm 22 ga teflon catheter (Insyte-W, BD, Franklin NJ) and the cut distal end of an angled introducer (Frova Introducer, Cook Medical, Bloomington IN). Other methods of tracheal intubation are acceptable, however, use of the angled introducer allows proper positioning of the neck in a slightly extended position, which optimizes surgical exposure for placement of the intravenous catheter. The endotracheal catheter hub is secured with a loop of suture to the incisor and maintained with slight tension to im...