Literature DB >> 22922476

A xenon recirculating ventilator for the newborn piglet: developing clinical applications of xenon for neonates.

Stuart D Faulkner1, Neil A Downie, Christopher J Mercer, Stuart A Kerr, Robert D Sanders, Nicola J Robertson.   

Abstract

CONTEXT: The clinical applications of xenon for the neonate include both anaesthesia and neuroprotection. However, due to the limited natural availability of xenon, special equipment is required to administer and recapture the gas to develop xenon as a therapeutic agent.
OBJECTIVE: In order to test the xenon recirculating ventilator for the application of neuroprotection in a preclinical trial, our primary objective was to test the efficiency, reliability and safety of administering 50% xenon for 24 h in hypoxic ischaemic piglets.
DESIGN: A prospective observational study.
SETTING: Institute for Women's Health, University College London, January 2008 to March 2008. ANIMALS: Four anaesthetised male piglets, less than 24 h old, underwent a global hypoxic ischaemic insult for approximately 25 min prior to switching to the xenon recirculating ventilator. INTERVENTION: Between 2 and 26 h after hypoxic ischaemia, anaesthetised piglets were administered a mixture of 50% xenon, air, oxygen and isoflurane. MAIN OUTCOME MEASURES: The primary outcome measure was blood gas PaCO2 (kPa) and secondary outcome measure was xenon gas use (l h), over the 24-h duration of xenon administration.
RESULTS: The xenon recirculating ventilator provided effective ventilation, automated control of xenon/air gas mixtures, and stable blood gas PaCO2 (4.5 to 6.3 kPa) for 24 h of ventilation with the xenon recirculating ventilator. Total xenon use was minimal at approximately 0.6 l h at a cost of approximately &OV0556;8 h. Additional features included an isoflurane scavenger and bellows height alarm.
CONCLUSION: Stable gas delivery to a piglet with minimal xenon loss and analogue circuitry made the xenon recirculating ventilator easy to use and it could be modified for other large animals and noble gas mixtures. The technologies, safety and efficiency of xenon delivery in this preclinical system have been taken forward in the development of neonatal ventilators for clinical use in phase II clinical trials for xenon-augmented hypothermia and for xenon anaesthesia.

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Year:  2012        PMID: 22922476     DOI: 10.1097/EJA.0b013e3283583c4b

Source DB:  PubMed          Journal:  Eur J Anaesthesiol        ISSN: 0265-0215            Impact factor:   4.330


  9 in total

Review 1.  The challenge of understanding cerebral white matter injury in the premature infant.

Authors:  C M Elitt; P A Rosenberg
Journal:  Neuroscience       Date:  2014-05-15       Impact factor: 3.590

Review 2.  Hydrogen and therapeutic gases for neonatal hypoxic-ischemic encephalopathy: potential neuroprotective adjuncts in translational research.

Authors:  Yinmon Htun; Shinji Nakamura; Takashi Kusaka
Journal:  Pediatr Res       Date:  2020-06-06       Impact factor: 3.756

3.  Neuroprotection by argon ventilation after perinatal asphyxia: a safety study in newborn piglets.

Authors:  Thomas Alderliesten; Laurent M A Favie; Robert W Neijzen; Volker Auwärter; Cora H A Nijboer; Roland E J Marges; Carin M A Rademaker; Jürgen Kempf; Frank van Bel; Floris Groenendaal
Journal:  PLoS One       Date:  2014-12-02       Impact factor: 3.240

4.  Inhaled 45-50% argon augments hypothermic brain protection in a piglet model of perinatal asphyxia.

Authors:  Kevin D Broad; Igor Fierens; Bobbi Fleiss; Eridan Rocha-Ferreira; Mojgan Ezzati; Jane Hassell; Daniel Alonso-Alconada; Alan Bainbridge; Go Kawano; Daqing Ma; Ilias Tachtsidis; Pierre Gressens; Xavier Golay; Robert D Sanders; Nicola J Robertson
Journal:  Neurobiol Dis       Date:  2015-12-10       Impact factor: 5.996

Review 5.  Current and Emerging Therapies in the Management of Hypoxic Ischemic Encephalopathy in Neonates.

Authors:  Jayasree Nair; Vasantha H S Kumar
Journal:  Children (Basel)       Date:  2018-07-19

6.  Intermittent exposure to xenon protects against gentamicin-induced nephrotoxicity.

Authors:  Ping Jia; Jie Teng; Jianzhou Zou; Yi Fang; Suhua Jiang; Xiaofang Yu; Alison J Kriegel; Mingyu Liang; Xiaoqiang Ding
Journal:  PLoS One       Date:  2013-05-30       Impact factor: 3.240

7.  Xenon: a solution for anesthesia in liver disease?

Authors:  Ali Dabbagh; Samira Rajaei
Journal:  Hepat Mon       Date:  2012-11-20       Impact factor: 0.660

Review 8.  Therapeutic Hypothermia for Neonatal Hypoxic-Ischemic Encephalopathy - Where to from Here?

Authors:  Joanne O Davidson; Guido Wassink; Lotte G van den Heuij; Laura Bennet; Alistair J Gunn
Journal:  Front Neurol       Date:  2015-09-14       Impact factor: 4.003

9.  Moderate hypothermia within 6 h of birth plus inhaled xenon versus moderate hypothermia alone after birth asphyxia (TOBY-Xe): a proof-of-concept, open-label, randomised controlled trial.

Authors:  Denis Azzopardi; Nicola J Robertson; Alan Bainbridge; Ernest Cady; Geoffrey Charles-Edwards; Aniko Deierl; Gianlorenzo Fagiolo; Nicholas P Franks; James Griffiths; Joseph Hajnal; Edmund Juszczak; Basil Kapetanakis; Louise Linsell; Mervyn Maze; Omar Omar; Brenda Strohm; Nora Tusor; A David Edwards
Journal:  Lancet Neurol       Date:  2015-12-19       Impact factor: 44.182

  9 in total

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