Xenon produces minimal haemodynamic effects in rabbits with chronically compromised left ventricular function

Preckel, Benedikt; Schlack, W.; Heibel, T.; Rütten, Hartmut

doi:10.1093/bja/88.2.264

Cited by 55 publications

(31 citation statements)

References 22 publications

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“…It is an effective anesthetic with a very rapid onset, no metabolism by the body, and no proven adverse hemodynamic clinical side effects, unlike many other inhaled agents. [12][13][14][15] However, xenon is expensive, which has limited its clinical use. Xenon has been shown recently to be neuroprotective in vitro and in vivo in rats when administered during hypoxia.…”

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confidence: 99%

Xenon Provides Short-Term Neuroprotection in Neonatal Rats When Administered After Hypoxia-Ischemia

Dingley

Tooley

Porter

et al. 2006

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Background and Purpose-Brain injury after hypoxic-ischemic insults evolves via an apoptotic/necrotic cascade.Glutamate over release and N-methyl-D-aspartate (NMDA) receptor over activation (excitotoxicity) are believed to trigger this process. Xenon is a nontoxic anesthetic gas that reduces neurotransmitter release and functionally antagonizes NMDA receptors. Administering xenon to hypoxic-ischemic newborns might be clinically effective if the neurotoxic processes continue evolving after delivery. We sought to determine whether xenon administration after the initial hypoxic-ischemic insult was neuroprotective. Methods-Fifty 7-day-old rats received a 90-minute hypoxic insult after unilateral carotid ligation. They were then randomized to breathe 1 of 2 gas mixtures for 3 hours: 50% Xe/30% O 2 /20% N 2 or 30% O 2 /70% N 2 . Results-One week after hypoxic-ischemic survival, significant global protection was seen in the xenon group (80% less injury); cortex/white matter (88% versus 25%), hippocampus (62% versus 0%), basal ganglia (81% versus 25%), and thalamus (50% versus 0%; percentage of global damage score in nonxenon versus xenon groups, respectively). Conclusions-Three hours of xenon administration commenced after hypoxia-ischemia in neonatal rats provides short-term neuroprotection. This finding suggests that treatment with xenon after perinatal asphyxia would also be neuroprotective. Because xenon does not cause other neurotoxic effects and has demonstrated minimal side effects in extensive anesthesia studies, it would make an ideal candidate for the treatment after human perinatal hypoxia-ischemia.

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mentioning

confidence: 99%

Xenon Provides Short-Term Neuroprotection in Neonatal Rats When Administered After Hypoxia-Ischemia

Dingley

Tooley

Porter

et al. 2006

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180

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“…Clinically and experimentally, xenon has shown favourable effects with respect to haemodynamic stability and cardiac function in a variety of species, including humans, in both in vivo and in vitro studies [3][4][5][20][21][22][23][24][25]. However, the impact of these findings on morbidity and mortality in high risk surgical patients is unknown.…”

Section: Discussionmentioning

confidence: 99%

“…More importantly, animal studies and data from humans suggest a high degree of cardiovascular stability during xenon anaesthesia [2,3], mainly attributable to the lack of effects of xenon on cardiac ion channels [4]. In animal experiments, xenon has been shown to produce minimal haemodynamic effects during chronically compromised left ventricular function [5] and to mitigate reperfusion injury during cardiopulmonary bypass [6]. Furthermore, it has been demonstrated that xenon exerts preconditioning comparable to volatile anaesthetics [7] and neuroprotective effects, as it acts via inhibition of N-methyl-D-aspartate (NMDA) receptors [8].…”

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Comparison of xenon‐based anaesthesia compared with total intravenous anaesthesia in high risk surgical patients*

et al. 2005

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SummaryXenon, a noble gas with anaesthetic and analgesic properties, has gained renewed interest due to its favourable physical properties which allow a rapid emergence from anaesthesia. However, high costs limit its use to a subset of patients who may benefit from xenon, thereby offsetting its costs. To date, there are only limited data available on the performance of xenon in high risk patients. We studied 39 patients with ASA physical status III undergoing aortic surgery. The patients were randomly assigned to either a xenon (Xe, n = 20) or a TIVA (T, n = 19) group. Global cardiac performance and myocardial contractility were assessed using transoesophageal echocardiography, and myocardial cell damage with troponin T and CK-MB. Echocardiographic measurements were made prior to xenon administration, following xenon administration, and after clamping of the abdominal aorta, after declamping and at corresponding time points in the TIVA group. Laboratory values were determined repeatedly for up to 72 h. Data were analysed using two-way ANOVA factoring for time and anaesthetic agent or with ANCOVA comparing linear regression lines. No significant differences were found in global myocardial performance, myocardial contractility or laboratory values at any time during the study period. Mean (SEM) duration of stay on the ICU (xenon: 38 ± 46 vs. TIVA 25 ± 15 h) or in hospital (xenon: 14 ± 12 vs. TIVA 10 ± 6 days) did not differ significantly between the groups. Although xenon has previously been shown to exert superior haemodynamic stability, we were unable to demonstrate an advantage of xenon-based anaesthesia compared to TIVA in high risk surgical patients.

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“…26 A estabilidade hemodinâmica e a ausência de efeito depressor miocárdico parece ser extensível ao miocárdio insuficiente, tendo sido demonstrada em estudos animais com miocárdio insuficiente, cardiomiopá-tico 27 ou com função ventricular esquerda comprometida. 28 No entanto, não há dados comprovativos desta estabilidade no miocárdio insuficiente em seres humanos. Uma vez que os anestésicos halogenados possuem propriedades cardioprotectoras na isquemia ou lesão miocárdica, fenómeno designado por precondicionamento farmacológico, 6 vários estudos têm investigado o xénon no mesmo contexto.…”

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Como Funciona o Xénon: Mecanismos de Neuro e Cardioprotecção

et al. 2014

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Xenon produces minimal haemodynamic effects in rabbits with chronically compromised left ventricular function

Abstract: These data show that xenon has only minimal negative inotropic effects in rabbits with LV dysfunction after coronary artery ligation.

Cited by 55 publications

References 22 publications

Xenon Provides Short-Term Neuroprotection in Neonatal Rats When Administered After Hypoxia-Ischemia

Xenon Provides Short-Term Neuroprotection in Neonatal Rats When Administered After Hypoxia-Ischemia

Comparison of xenon‐based anaesthesia compared with total intravenous anaesthesia in high risk surgical patients*

Como Funciona o Xénon: Mecanismos de Neuro e Cardioprotecção

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