FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2154521304> ?p ?o ?g. }

• W2154521304 endingPage "789" @default.
• W2154521304 startingPage "786" @default.
• W2154521304 abstract "Xenon† is called a ‘rare’, ‘noble’ or ‘inert’ gas, all synonyms used for the eighth group of the periodic table of the elements. Of this group, xenon is the only gas with significant anaesthetic properties, which have been recognized for more than five decades.1Cullen SC Gross EG. The anesthetic properties of xenon in animals and human beings, with additional observations on krypton.Science. 1951; 113: 580-583Crossref PubMed Scopus (329) Google Scholar Its rarity—xenon represents only 0.0875 p.p.m. of the atmosphere— combined with the inability to synthesize the gas rendered xenon noble, and the resulting high cost prohibited its routine use as an inhalational anaesthetic. Thus, xenon is a rare and a noble gas, but is it also inert? There is increasing evidence from experimental data that, although chemically inert, xenon may cause several physiological changes. These biological side‐effects could mediate organ protection and the use of xenon might therefore be beneficial in certain clinical situations. Sanders and colleagues2Sanders RD Franks NP Maze M. Xenon: no stranger to anaesthesia.Br J Anaesth. 2003; 91: 709-717Crossref PubMed Scopus (90) Google Scholar published an excellent review in this journal in 2003, summarizing the advantages of xenon anaesthesia in comparison with the commonly used anaesthetic agents. They highlighted one of the areas in which xenon might become clinically important in the future: xenon is an inhibitor of the glutamatergic N‐methyl‐d‐aspartate (NMDA) receptor,3Franks NP Dickinson R De Sousa SL Hall AC Lieb WR How does xenon produce anaesthesia?.Nature. 1998; 396: 324Crossref PubMed Scopus (458) Google Scholar which can initiate neuronal injury if stimulated. Xenon may therefore serve as a neuroprotective agent. These neuroprotective properties of xenon have been investigated in several recent studies.2Sanders RD Franks NP Maze M. Xenon: no stranger to anaesthesia.Br J Anaesth. 2003; 91: 709-717Crossref PubMed Scopus (90) Google Scholar A second use of xenon during anaesthesia might be in patients at high risk of cardiac failure and myocardial ischaemia. The haemodynamic stability during xenon anaesthesia has often been cited. However, there is a discrepancy between the increasing amount of experimental data and the lack of larger clinical studies. Most studies on the effects of xenon have been performed in small patient groups.4Luttropp HH Romner B Perhag L Eskilsson J Fredriksen S Werner O. Left ventricular performance and cerebral haemodynamics during xenon anaesthesia. A transoesophageal echocardiography and transcranial Doppler sonography study.Anaesthesia. 1993; 48: 1045-1049Crossref PubMed Scopus (108) Google Scholar, 5Nakata Y Goto T Morita S. Effects of xenon on hemodynamic responses to skin incision in humans.Anesthesiology. 1999; 90: 406-410Crossref PubMed Scopus (35) Google Scholar, 6Dingley J King R Hughes L et al.Exploration of xenon as a potential cardiostable sedative: a comparison with propofol after cardiac surgery.Anaesthesia. 2001; 56: 829-835Crossref PubMed Scopus (54) Google Scholar Only one multicentre study included a larger number of 112 patients.7Rossaint R Reyle‐Hahn M Schulte am Esch J et al.Multicenter randomized comparison of the efficacy and safety of xenon and isoflurane in patients undergoing elective surgery.Anesthesiology. 2003; 98: 6-13Crossref PubMed Scopus (179) Google Scholar In addition, in the clinical studies and most of the experimental investigations, data were obtained from subjects with healthy myocardium. So far, no data are available from patients with compromised myocardium or haemodynamic instability. This editorial will summarize the cardiovascular effects of xenon, addressing the question of whether investigation of the effects of xenon in ASA III and ASA IV patients may be justified. In in vitro experiments, xenon had no significant effects on the myocardium; in isolated, buffer perfused rat hearts, a mixture of xenon 50%, oxygen 45% and carbon dioxide 5% had no effect on coronary perfusion pressure, heart rate or left ventricular developed pressure (calculated as left ventricular peak systolic minus end‐diastolic pressure) compared with nitrogen 50% oxygen 45% and carbon dioxide 5%.8Nakayama H Takahashi H Okubo N Miyabe M Toyooka H. Xenon and nitrous oxide do not depress cardiac function in an isolated rat heart model.Can J Anesth. 2002; 49: 375-379Crossref PubMed Scopus (14) Google Scholar However, in these experiments, oxygen delivery to the heart was 50% lower than in the control state, resulting itself in reduced contractility in control hearts. In isolated guinea pig hearts, xenon 40–80% did not significantly alter heart rate, artrioventricular conduction time, left ventricular pressure, coronary flow, oxygen extraction or consumption, cardiac efficiency, or flow responses to bradykinin.9Stowe DF Rehmert GC Kwok WM Weigt HU Georgieff M Bosnjak ZJ. Xenon does not alter cardiac function or major cation currents in isolated guinea pig hearts or myocytes.Anesthesiology. 2000; 92: 516-522Crossref PubMed Scopus (69) Google Scholar In isolated cardiomyocytes, the amplitudes of the sodium, the L‐type calcium and the inward‐rectifier potassium channel were not altered by xenon 80%, suggesting that the noble gas does not affect the cardiac action potential.9Stowe DF Rehmert GC Kwok WM Weigt HU Georgieff M Bosnjak ZJ. Xenon does not alter cardiac function or major cation currents in isolated guinea pig hearts or myocytes.Anesthesiology. 2000; 92: 516-522Crossref PubMed Scopus (69) Google Scholar These results indicate that xenon has no physiologically important effects on the guinea‐pig heart. Xenon did not depress L‐type calcium currents in human atrial myocytes,10Hüneke R Jüngling E Skasa M Rossaint R Lückhoff A. Effects of the anesthetic gases xenon, halothane, and isoflurane on calcium and potassium currents in human atrial cardiomyocytes.Anesthesiology. 2001; 95: 999-1006Crossref PubMed Scopus (69) Google Scholar did not depress myocardial contractility and did not influence the positive inotropic stimulation of isoproterenol or the force‐frequency relation in cardiac muscle bundles.11Schroth S Schotten U Alkanoglu O Reyle‐Hahn M Hanrath P Rossaint R. Xenon does not impair the responsiveness of cardiac muscle bundles to positive inotropic and chronotropic stimulation.Anesthesiology. 2002; 96: 422-427Crossref PubMed Scopus (34) Google Scholar While in vitro experiments can be performed in the absence of other anaesthetics, in vivo studies with xenon normally use supplementary baseline anaesthesia because the MAC of xenon in animals is higher than 80 vol %. In pentobarbital‐anaesthetized pigs, cardiac index, central venous pressure, aortic pressure and systemic vascular resistance were not significantly altered by xenon 30–70%.12Marx T Wagner D Bäder S Görtz A Georgieff M Fröba G. Hemodynamics and catecholamines in anesthesia with different concentrations of xenon.ACP. 1998; 7: 215-221Google Scholar In isoflurane‐anaesthetized dogs, the coupling between oxygen consumption and cardiac output was maintained during xenon inhalation.13Picker O Schindler AW Schwarte LA et al.Xenon increases total body oxygen consumption during isoflurane anaesthesia in dogs.Br J Anaesth. 2002; 88: 546-554Crossref PubMed Scopus (12) Google Scholar The cardiovascular stability was accompanied by increased oxygen consumption, which was independent of the autonomic nervous system. In midazolam–piritramide‐anaesthetized dogs, inhalation of up to xenon 70% had no effect on myocardial function.14Preckel B Ebel D Müllenheim J Frässdorf J Thämer V Schlack W. The direct myocardial effects of xenon in the dog heart in vivo.Anesth Analg. 2002; 94: 545-551Crossref PubMed Scopus (30) Google Scholar In contrast, regional administration of xenon 70% directly into the coronary artery reduced the indices of regional myocardial contractility measured by sonomicrometry by about 8%, indicating a small negative inotropic effect in vivo. Compared with the negative inotropic action of isoflurane, this effect was negligible.14Preckel B Ebel D Müllenheim J Frässdorf J Thämer V Schlack W. The direct myocardial effects of xenon in the dog heart in vivo.Anesth Analg. 2002; 94: 545-551Crossref PubMed Scopus (30) Google Scholar Most clinical studies investigating the cardiovascular effects of xenon compared its effects with those of another routinely used anaesthetic agent. No significant effect on arterial blood pressure could be observed in patients anaesthetized with xenon 70% in comparison with those anaesthetized with nitrous oxide. Fractional area change obtained by echocardiography was not altered by xenon 65% in healthy patients.4Luttropp HH Romner B Perhag L Eskilsson J Fredriksen S Werner O. Left ventricular performance and cerebral haemodynamics during xenon anaesthesia. A transoesophageal echocardiography and transcranial Doppler sonography study.Anaesthesia. 1993; 48: 1045-1049Crossref PubMed Scopus (108) Google Scholar The only change observed was a tendency to a decreased heart rate accompanied by increased variability of the cardiac rhythm.4Luttropp HH Romner B Perhag L Eskilsson J Fredriksen S Werner O. Left ventricular performance and cerebral haemodynamics during xenon anaesthesia. A transoesophageal echocardiography and transcranial Doppler sonography study.Anaesthesia. 1993; 48: 1045-1049Crossref PubMed Scopus (108) Google Scholar 5Nakata Y Goto T Morita S. Effects of xenon on hemodynamic responses to skin incision in humans.Anesthesiology. 1999; 90: 406-410Crossref PubMed Scopus (35) Google Scholar In addition, xenon produces analgesia, thereby suppressing haemodynamic and catecholamine responses to surgical stimulation. The interpretation of these clinical studies is limited by the small numbers of patients included. In the first randomized controlled multicentre trial, xenon provided safe and effective anaesthesia in 112 patients, and resulted in faster recovery compared with isoflurane–nitrous oxide anaesthesia.7Rossaint R Reyle‐Hahn M Schulte am Esch J et al.Multicenter randomized comparison of the efficacy and safety of xenon and isoflurane in patients undergoing elective surgery.Anesthesiology. 2003; 98: 6-13Crossref PubMed Scopus (179) Google Scholar In the xenon group, a higher mean arterial pressure and a more pronounced decrease in heart rate from baseline was observed. The need for inotropic substances was lower in the xenon group, whereas the need for antihypertensives was greater. However, patients at high risk of undesirable cardiac events were excluded from the study. In isoflurane‐anaesthetized dogs with dilated cardiomyopathy, xenon decreased heart rate and increased the time constant of left ventricular relaxation, but had no effect on arterial or left ventricular pressures or the indices of left ventricular preload and afterload.15Hettrick DA Pagel PS Kersten JR et al.Cardiovascular effects of xenon in isoflurane‐anesthetized dogs with dilated cardiomyopathy.Anesthesiology. 1998; 89: 1166-1173Crossref PubMed Scopus (78) Google Scholar In rabbits with chronically compromised left ventricular function 9 weeks after permanent coronary artery occlusion, the inhalation of xenon 70% had no effect on left ventricular function measured by echocardiography in closed‐chest animals.16Preckel B Schlack W Heibel T Rütten H. Xenon produces minimal haemodynamic effects in rabbits with chronically compromised left ventricular function.Br J Anaesth. 2002; 88: 264-269Crossref PubMed Scopus (48) Google Scholar With invasive measurements, a decrease in left ventricular pressure and left ventricular dP/dt of 10% was observed, indicating only a small negative inotropic effect. In the presence of regional myocardial ischaemia and reperfusion, xenon caused a small reduction in cardiac output and an increase in mean aortic pressure, resulting in an increase in systemic vascular resistance.17Preckel B Müllenheim J Moloschavij A Thämer V Schlack W. Xenon administration during early reperfusion reduces infarct size after regional ischemia in the rabbit heart in vivo.Anesth Analg. 2000; 91: 1327-1332Crossref PubMed Scopus (102) Google Scholar Xenon also has cardioprotective effects: given during reperfusion, it reduced infarct size after regional myocardial ischaemia in rabbits in vivo.17Preckel B Müllenheim J Moloschavij A Thämer V Schlack W. Xenon administration during early reperfusion reduces infarct size after regional ischemia in the rabbit heart in vivo.Anesth Analg. 2000; 91: 1327-1332Crossref PubMed Scopus (102) Google Scholar In addition, xenon can protect the heart against the consequences of ischaemia by pharmacological preconditioning.18Toma O Weber NC Obal D Preckel B Schlack W. Xenon induces myocardial protection by preconditioning. Involvement of protein kinase C (PKC).ASA Abstracts. 2003; : A1540Google Scholar This effect is mediated by activation of the isoform Ε of protein kinase C, by a translocation of protein kinase C from the cytosol to the cell membrane, and by the p38 mitogen‐activated protein kinase.18Toma O Weber NC Obal D Preckel B Schlack W. Xenon induces myocardial protection by preconditioning. Involvement of protein kinase C (PKC).ASA Abstracts. 2003; : A1540Google Scholar Only one study has investigated the effects of xenon in patients with pre‐existing cardiac disease. Postoperative sedation with xenon–remifentanil in patients after coronary artery bypass grafting did not affect heart rate and mean aortic pressure compared with propofol sedation.6Dingley J King R Hughes L et al.Exploration of xenon as a potential cardiostable sedative: a comparison with propofol after cardiac surgery.Anaesthesia. 2001; 56: 829-835Crossref PubMed Scopus (54) Google Scholar In contrast to propofol sedation, xenon had no vasodilatory effects in patients with cardiovascular impairment and there were no negative effects on myocardial contractility, as determined by left ventricular stroke work index.6Dingley J King R Hughes L et al.Exploration of xenon as a potential cardiostable sedative: a comparison with propofol after cardiac surgery.Anaesthesia. 2001; 56: 829-835Crossref PubMed Scopus (54) Google Scholar In this investigation, only 10 patients were studied and the mean xenon concentration used for sedation was 27.4 (sd 11.8)%, much lower than the concentrations necessary for anaesthesia. Xenon has been safely used in a patient with Eisenmenger's syndrome, in whom the main concern was a reduction in systemic vascular resistance.19Hofland J Gültuna I Tenbrinck R. Xenon anaesthesia for laparoscopic cholecystectomy in a patient with Eisenmenger's syndrome.Br J Anaesth. 2001; 86: 882-886Crossref PubMed Scopus (20) Google Scholar Patients with Eisenmenger's syndrome have lost the ability to adapt to sudden haemodynamic changes because of end‐stage pulmonary vascular disease, and may benefit from the stable haemodynamics of xenon anaesthesia. There is still limited information about the use of xenon during extracorporeal cardiopulmonary bypass. In rats, cardiopulmonary bypass‐induced neurological and neurocognitive dysfunction was attenuated by xenon 60%.20Ma D Yang H Lynch J Franks NP Maze M Grocott HP. Xenon attenuates cardiopulmonary bypass‐induced neurologic and neurocognitive dysfunction in the rat.Anesthesiology. 2003; 98: 690-698Crossref PubMed Scopus (143) Google Scholar In these experiments, xenon was added to the bypass circuit after the blood had passed through the oxygenator. One major problem with the use of xenon during cardiopulmonary bypass is that the noble gas is eliminated during extracorporeal circulation through the oxygenator,21Schirmer U Reinelt H Erber M Schmidt M Marx T. Xenon washout during in‐vitro extracorporeal circulation using different oxygenators.J Clin Monit Comput. 2002; 17: 211-215Crossref PubMed Scopus (5) Google Scholar and continuous xenon administration would be necessary to compensate for these losses, increasing substantially the cost of its use. There are no clinical data available on the use of xenon during heart surgery. In chronically instrumented dogs, cardiovascular stability during xenon anaesthesia was accompanied by an increase in total body oxygen consumption, probably caused by increased cell metabolism.13Picker O Schindler AW Schwarte LA et al.Xenon increases total body oxygen consumption during isoflurane anaesthesia in dogs.Br J Anaesth. 2002; 88: 546-554Crossref PubMed Scopus (12) Google Scholar In acutely instrumented dogs, xenon 70% given directly into the coronary artery had no effect on coronary blood flow.14Preckel B Ebel D Müllenheim J Frässdorf J Thämer V Schlack W. The direct myocardial effects of xenon in the dog heart in vivo.Anesth Analg. 2002; 94: 545-551Crossref PubMed Scopus (30) Google Scholar In pigs, regional perfusion in the brainstem, cerebral cortex, medulla oblongata and cerebellum was increased during xenon 79% inhalation.22Schmidt M Marx T Kotzerke J et al.Cerebral and regional organ perfusion in pigs during xenon anaesthesia.Anaesthesia. 2001; 56: 1154-1159Crossref PubMed Scopus (39) Google Scholar In these animals, no effect on liver, kidney, bowel, muscle, skin or cardiac blood flow was observed.22Schmidt M Marx T Kotzerke J et al.Cerebral and regional organ perfusion in pigs during xenon anaesthesia.Anaesthesia. 2001; 56: 1154-1159Crossref PubMed Scopus (39) Google Scholar The relationship between regional cerebral blood flow and cerebral glucose utilization was maintained, although reset at higher levels in rats.23Frietsch T Bogdanski R Blobner M Werner C Kuschinsky W Waschke KF. Effects of xenon on cerebral blood flow and cerebral glucose utilization in rats.Anesthesiology. 2001; 94: 290-297Crossref PubMed Scopus (28) Google Scholar No influence on regional cerebral blood flow and carbon dioxide autoregulation by up to xenon 70% was observed in propofol‐anaesthetized pigs24Fink H Blobner M Bogdanski R Hänel F Werner C Kochs E. Effects of xenon on cerebral blood flow and autoregulation: an experimental study in pigs.Br J Anaesth. 2000; 84: 221-225Crossref PubMed Scopus (29) Google Scholar or in pentobarbital‐anaesthetized rabbits.25Fukuda T Nakayama H Yanagi K et al.The effects of 30% and 60% xenon inhalation on pial vessel diameter and intracranial pressure in rabbits.Anesth Analg. 2001; 92: 1245-1250Crossref PubMed Scopus (18) Google Scholar In patients with severe head injury, xenon 33% produced an increase in intracranial pressure and decreased cerebral perfusion pressure, although no signs of cerebral ischaemia were observed,26Plougmann J Astrup J Pedersen J Gyldensted C. Effect of stable xenon inhalation on intracranial pressure during measurement of cerebral blood flow in head injury.J Neurosurg. 1994; 81: 822-828Crossref PubMed Scopus (43) Google Scholar and the observation that inhalation of xenon 25–35% increased cerebral blood flow has raised concern that xenon inhalation may be hazardous in patients with decreased intracranial compliance. In conclusion, current data indicate that xenon has relatively few, minor side‐effects, such as a small but clinically irrelevant negative inotropic effect and an increase in cerebral blood flow, and at the same time it may have neuro‐ and cardioprotective properties. Xenon anaesthesia may therefore become a therapeutic option for specific indications, such as patients with neurological disease, as recently summarized by Sanders and colleagues,2Sanders RD Franks NP Maze M. Xenon: no stranger to anaesthesia.Br J Anaesth. 2003; 91: 709-717Crossref PubMed Scopus (90) Google Scholar or for patients at high risk of cardiac ischaemia or with severely compromised myocardial function. However, xenon has been studied only in ASA I and II patients, and it is time to investigate whether ASA III and ASA IV patients will profit from xenon anaesthesia." @default.
• W2154521304 created "2016-06-24" @default.
• W2154521304 creator A5000626012 @default.
• W2154521304 creator A5002867682 @default.
• W2154521304 date "2004-06-01" @default.
• W2154521304 modified "2023-09-26" @default.
• W2154521304 title "Editorial III" @default.
• W2154521304 cites W1498753539 @default.
• W2154521304 cites W1512255408 @default.
• W2154521304 cites W1554577516 @default.
• W2154521304 cites W1633272553 @default.
• W2154521304 cites W1964649605 @default.
• W2154521304 cites W1964653009 @default.
• W2154521304 cites W1979634293 @default.
• W2154521304 cites W1981031446 @default.
• W2154521304 cites W1984037227 @default.
• W2154521304 cites W1987662138 @default.
• W2154521304 cites W1993237283 @default.
• W2154521304 cites W2007704350 @default.
• W2154521304 cites W200789894 @default.
• W2154521304 cites W2010482008 @default.
• W2154521304 cites W2010493309 @default.
• W2154521304 cites W2011527723 @default.
• W2154521304 cites W2012480099 @default.
• W2154521304 cites W2012635759 @default.
• W2154521304 cites W2019636064 @default.
• W2154521304 cites W2083229888 @default.
• W2154521304 cites W2105164613 @default.
• W2154521304 cites W2143148529 @default.
• W2154521304 cites W2155070293 @default.
• W2154521304 cites W2167473065 @default.
• W2154521304 doi "https://doi.org/10.1093/bja/aeh137" @default.
• W2154521304 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/15145831" @default.
• W2154521304 hasPublicationYear "2004" @default.
• W2154521304 type Work @default.
• W2154521304 sameAs 2154521304 @default.
• W2154521304 citedByCount "9" @default.
• W2154521304 countsByYear W21545213042013 @default.
• W2154521304 countsByYear W21545213042017 @default.
• W2154521304 countsByYear W21545213042018 @default.
• W2154521304 countsByYear W21545213042019 @default.
• W2154521304 crossrefType "journal-article" @default.
• W2154521304 hasAuthorship W2154521304A5000626012 @default.
• W2154521304 hasAuthorship W2154521304A5002867682 @default.
• W2154521304 hasBestOaLocation W21545213041 @default.
• W2154521304 hasConcept C121332964 @default.
• W2154521304 hasConcept C154256306 @default.
• W2154521304 hasConcept C177322064 @default.
• W2154521304 hasConcept C178790620 @default.
• W2154521304 hasConcept C185544564 @default.
• W2154521304 hasConcept C185592680 @default.
• W2154521304 hasConcept C192562407 @default.
• W2154521304 hasConcept C548442186 @default.
• W2154521304 hasConceptScore W2154521304C121332964 @default.
• W2154521304 hasConceptScore W2154521304C154256306 @default.
• W2154521304 hasConceptScore W2154521304C177322064 @default.
• W2154521304 hasConceptScore W2154521304C178790620 @default.
• W2154521304 hasConceptScore W2154521304C185544564 @default.
• W2154521304 hasConceptScore W2154521304C185592680 @default.
• W2154521304 hasConceptScore W2154521304C192562407 @default.
• W2154521304 hasConceptScore W2154521304C548442186 @default.
• W2154521304 hasIssue "6" @default.
• W2154521304 hasLocation W21545213041 @default.
• W2154521304 hasLocation W21545213042 @default.
• W2154521304 hasOpenAccess W2154521304 @default.
• W2154521304 hasPrimaryLocation W21545213041 @default.
• W2154521304 hasRelatedWork W2010482008 @default.
• W2154521304 hasVolume "92" @default.
• W2154521304 isParatext "false" @default.
• W2154521304 isRetracted "false" @default.
• W2154521304 magId "2154521304" @default.
• W2154521304 workType "article" @default.