Pub Date : 2024-11-15DOI: 10.1213/ane.0000000000006908
Martina Bordini, Calvin Lo, Clyde T. Matava
An abstract is unavailable.
没有摘要。
{"title":"Evaluation and Acceptance of Open-Source 3D-Printed Tracheobronchial Tree Models for Improving Pediatric Lung Isolation Techniques Training","authors":"Martina Bordini, Calvin Lo, Clyde T. Matava","doi":"10.1213/ane.0000000000006908","DOIUrl":"https://doi.org/10.1213/ane.0000000000006908","url":null,"abstract":"An abstract is unavailable.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142670731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-15DOI: 10.1213/ane.0000000000006991
Joanna A. Kountanis, Tracey M. Vogel
An abstract is unavailable.
没有摘要。
{"title":"Unveiling the Anesthesiologist’s Impact on Childbirth-Related Posttraumatic Stress Disorder","authors":"Joanna A. Kountanis, Tracey M. Vogel","doi":"10.1213/ane.0000000000006991","DOIUrl":"https://doi.org/10.1213/ane.0000000000006991","url":null,"abstract":"An abstract is unavailable.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142670785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-15DOI: 10.1213/ane.0000000000007233
James R. Nielsen
An abstract is unavailable.
没有摘要。
{"title":"Sugammadex versus Neostigmine in Renal Impairment","authors":"James R. Nielsen","doi":"10.1213/ane.0000000000007233","DOIUrl":"https://doi.org/10.1213/ane.0000000000007233","url":null,"abstract":"An abstract is unavailable.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142670729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-15DOI: 10.1213/ane.0000000000007198
Karen Semaan, Dmitry Tumin
An abstract is unavailable.
没有摘要。
{"title":"Middle Eastern and North African: Recognizing the New US Census Category in Anesthesiology Research and Practice","authors":"Karen Semaan, Dmitry Tumin","doi":"10.1213/ane.0000000000007198","DOIUrl":"https://doi.org/10.1213/ane.0000000000007198","url":null,"abstract":"An abstract is unavailable.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142670733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-15DOI: 10.1213/ane.0000000000007232
Timothy W. Martin, Elizabeth A. Steele
An abstract is unavailable.
没有摘要。
{"title":"Substance-Use Disorders in Young Patients—Much More Than Preop Questions and Potential for Drug Interactions","authors":"Timothy W. Martin, Elizabeth A. Steele","doi":"10.1213/ane.0000000000007232","DOIUrl":"https://doi.org/10.1213/ane.0000000000007232","url":null,"abstract":"An abstract is unavailable.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142670734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-15DOI: 10.1213/ane.0000000000007156
Heena Garg, Vishnu Narayanan M R., Puneet Khanna, Bharat Yalla
US Clinical registry databases were searched. Studies comparing phenylephrine boluses (both therapeutic and prophylactic) with infusion (both fixed- and variable-rate) assessing various feto-maternal outcomes were included. The primary outcome was the incidence of maternal hypotension. Secondary maternal outcomes included the incidence of reactive hypertension, bradycardia, nausea, or vomiting; secondary neonatal outcomes included umbilical arterial pH, partial pressure of oxygen (paO2), umbilical venous pH, fetal acidosis, Apgar Scores at 1 and 5 minutes. All outcomes were quantitatively analyzed using the random effects model. Risk of bias was assessed using the Cochrane Collaboration R0B 2.0 tool. RESULTS: We included 15 studies with 2153 parturients. The parturients receiving phenylephrine bolus during cesarean delivery under spinal or combined spinal-epidural anesthesia had a significant increase in the incidence of predelivery hypotension compared to phenylephrine infusion (risk ratio [RR], 2.34, 95% confidence interval [CI], 1.72–3.18). Reactive hypertension (RR, 0.48, 95% CI, 0.29–0.79) and bradycardia (RR, 0.57, 95% CI, 0.41–0.79) were less common in the parturients receiving phenylephrine bolus; whereas, vomiting (RR, 2.15, 95% CI, 1.53–3.03) was more common compared to the infusion group. No statistically significant difference was observed in the incidence of nausea or any fetal outcomes (umbilical artery pH, paO2, umbilical venous pH, fetal acidosis, and Apgar scores at 1 and 5 minutes) between either of the groups. Three studies had a high risk of bias. CONCLUSIONS: A prophylactic phenylephrine infusion significantly reduces the incidence of predelivery hypotension in parturients undergoing cesarean delivery under neuraxial anesthesia in comparison to the therapeutic or prophylactic phenylephrine bolus group. A prophylactic phenylephrine infusion may be considered in all parturients without preexisting hypertensive disorder or cardiovascular disorders to reduce the risk of predelivery hypotension. More evidence is needed to guide optimal hemodynamic management for patients with hypertensive or cardiovascular disorders....
{"title":"Comparison of Phenylephrine Bolus and Infusion Regimens on Maternal and Fetal Outcomes During Cesarean Delivery: A Systematic Review and Meta-Analysis","authors":"Heena Garg, Vishnu Narayanan M R., Puneet Khanna, Bharat Yalla","doi":"10.1213/ane.0000000000007156","DOIUrl":"https://doi.org/10.1213/ane.0000000000007156","url":null,"abstract":"US Clinical registry databases were searched. Studies comparing phenylephrine boluses (both therapeutic and prophylactic) with infusion (both fixed- and variable-rate) assessing various feto-maternal outcomes were included. The primary outcome was the incidence of maternal hypotension. Secondary maternal outcomes included the incidence of reactive hypertension, bradycardia, nausea, or vomiting; secondary neonatal outcomes included umbilical arterial pH, partial pressure of oxygen (paO2), umbilical venous pH, fetal acidosis, Apgar Scores at 1 and 5 minutes. All outcomes were quantitatively analyzed using the random effects model. Risk of bias was assessed using the Cochrane Collaboration R0B 2.0 tool. RESULTS: We included 15 studies with 2153 parturients. The parturients receiving phenylephrine bolus during cesarean delivery under spinal or combined spinal-epidural anesthesia had a significant increase in the incidence of predelivery hypotension compared to phenylephrine infusion (risk ratio [RR], 2.34, 95% confidence interval [CI], 1.72–3.18). Reactive hypertension (RR, 0.48, 95% CI, 0.29–0.79) and bradycardia (RR, 0.57, 95% CI, 0.41–0.79) were less common in the parturients receiving phenylephrine bolus; whereas, vomiting (RR, 2.15, 95% CI, 1.53–3.03) was more common compared to the infusion group. No statistically significant difference was observed in the incidence of nausea or any fetal outcomes (umbilical artery pH, paO2, umbilical venous pH, fetal acidosis, and Apgar scores at 1 and 5 minutes) between either of the groups. Three studies had a high risk of bias. CONCLUSIONS: A prophylactic phenylephrine infusion significantly reduces the incidence of predelivery hypotension in parturients undergoing cesarean delivery under neuraxial anesthesia in comparison to the therapeutic or prophylactic phenylephrine bolus group. A prophylactic phenylephrine infusion may be considered in all parturients without preexisting hypertensive disorder or cardiovascular disorders to reduce the risk of predelivery hypotension. More evidence is needed to guide optimal hemodynamic management for patients with hypertensive or cardiovascular disorders....","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"197 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142670786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-25DOI: 10.1213/ane.0000000000007315
Eline Kho,Rogier V Immink,Bjorn J P van der Ster,Ward H van der Ven,Jimmy Schenk,Markus W Hollmann,Johan T M Tol,Lotte E Terwindt,Alexander P J Vlaar,Denise P Veelo
BACKGROUNDPostinduction hypotension (PIH) may be associated with increased morbidity and mortality. In earlier studies, the definition of PIH is solely based on different absolute or relative thresholds. However, the time-course (eg, how fast blood pressure drops during induction) is rarely incorporated, whereas it might represent the hemodynamic instability of a patient. We propose a comprehensive model to distinguish hemodynamically unstable from stable patients by combining blood pressure thresholds with the magnitude and speed of decline.METHODSThis prospective study included 375 adult elective noncardiac surgery patients. Noninvasive blood pressure was continuously measured between 5 minutes before up to 15 minutes after the first induction agent had been administered. An expert panel rated whether the patient experienced clinically relevant hemodynamic instability or not. Interrater correlation coefficient and intraclass correlation were computed to check for consistency between experts. Next, an automated classification model for clinically relevant hemodynamic instability was developed using mean, maximum, minimum systolic, mean, diastolic arterial blood pressure (SAP, MAP, and DAP, respectively) and their corresponding time course of decline. The model was trained and tested based on the hemodynamic instability labels provided by the experts.RESULTSIn total 78 patients were classified as having experienced hemodynamic instability and 279 as not. The hemodynamically unstable patients were significantly older (7 years, 95% confidence interval (CI), 4-11, P < .001), with a higher prevalence of chronic obstructive pulmonary disease (COPD) (3% higher, 95% CI, 1-8, P = .036). Before induction, hemodynamically unstable patients had a higher SAP (median (first-third quartile): 161 (145-175) mm Hg vs 150 (134-166) mm Hg, P < .001) compared to hemodynamic stable patients. Interrater agreement between experts was 0.92 (95% CI, 0.89-0.94). The random forest classifier model showed excellent performance with an area under the receiver operating curve (AUROC) of 0.96, a sensitivity of 0.84, and specificity of 0.94.CONCLUSIONSBased on the high sensitivity and specificity, the developed model is able to differentiate between clinically relevant hemodynamic instability and hemodynamic stable patients. This classification model will pave the way for future research concerning hemodynamic instability and its prevention.
背景诱导后低血压（PIH）可能与发病率和死亡率的增加有关。在早期的研究中，PIH 的定义仅基于不同的绝对或相对阈值。然而，时间过程（如诱导过程中血压下降的速度）很少被纳入其中，而这可能代表了患者血液动力学的不稳定性。我们提出了一个综合模型，通过将血压阈值与血压下降的幅度和速度相结合来区分血流动力学不稳定和稳定的患者。在使用第一种诱导剂前 5 分钟至使用后 15 分钟期间，连续测量无创血压。专家小组对患者是否出现临床相关的血流动力学不稳定进行评分。计算了专家间相关系数和类内相关性，以检查专家间的一致性。接下来，利用收缩压、舒张压和平均动脉压的平均值、最大值、最小值及其相应的下降时间过程，建立了临床相关血流动力学不稳定的自动分类模型。根据专家提供的血流动力学不稳定标签对模型进行了训练和测试。结果共有 78 名患者被归类为经历过血流动力学不稳定，279 名患者未经历过。血流动力学不稳定患者的年龄明显偏大（7 岁，95% 置信区间（CI），4-11，P < .001），慢性阻塞性肺病（COPD）的发病率更高（3%，95% CI，1-8，P = .036）。诱导前，血流动力学不稳定患者的 SAP 较高（中位数（第一至第三四分位数）：161（145-175））：161 (145-175) mm Hg vs 150 (134-166) mm Hg，P < .001）。专家之间的内部一致性为 0.92（95% CI，0.89-0.94）。随机森林分类器模型表现优异，接收者操作曲线下面积（AUROC）为 0.96，灵敏度为 0.84，特异度为 0.94。该分类模型将为今后有关血流动力学不稳定及其预防的研究铺平道路。
{"title":"Defining Postinduction Hemodynamic Instability With an Automated Classification Model.","authors":"Eline Kho,Rogier V Immink,Bjorn J P van der Ster,Ward H van der Ven,Jimmy Schenk,Markus W Hollmann,Johan T M Tol,Lotte E Terwindt,Alexander P J Vlaar,Denise P Veelo","doi":"10.1213/ane.0000000000007315","DOIUrl":"https://doi.org/10.1213/ane.0000000000007315","url":null,"abstract":"BACKGROUNDPostinduction hypotension (PIH) may be associated with increased morbidity and mortality. In earlier studies, the definition of PIH is solely based on different absolute or relative thresholds. However, the time-course (eg, how fast blood pressure drops during induction) is rarely incorporated, whereas it might represent the hemodynamic instability of a patient. We propose a comprehensive model to distinguish hemodynamically unstable from stable patients by combining blood pressure thresholds with the magnitude and speed of decline.METHODSThis prospective study included 375 adult elective noncardiac surgery patients. Noninvasive blood pressure was continuously measured between 5 minutes before up to 15 minutes after the first induction agent had been administered. An expert panel rated whether the patient experienced clinically relevant hemodynamic instability or not. Interrater correlation coefficient and intraclass correlation were computed to check for consistency between experts. Next, an automated classification model for clinically relevant hemodynamic instability was developed using mean, maximum, minimum systolic, mean, diastolic arterial blood pressure (SAP, MAP, and DAP, respectively) and their corresponding time course of decline. The model was trained and tested based on the hemodynamic instability labels provided by the experts.RESULTSIn total 78 patients were classified as having experienced hemodynamic instability and 279 as not. The hemodynamically unstable patients were significantly older (7 years, 95% confidence interval (CI), 4-11, P < .001), with a higher prevalence of chronic obstructive pulmonary disease (COPD) (3% higher, 95% CI, 1-8, P = .036). Before induction, hemodynamically unstable patients had a higher SAP (median (first-third quartile): 161 (145-175) mm Hg vs 150 (134-166) mm Hg, P < .001) compared to hemodynamic stable patients. Interrater agreement between experts was 0.92 (95% CI, 0.89-0.94). The random forest classifier model showed excellent performance with an area under the receiver operating curve (AUROC) of 0.96, a sensitivity of 0.84, and specificity of 0.94.CONCLUSIONSBased on the high sensitivity and specificity, the developed model is able to differentiate between clinically relevant hemodynamic instability and hemodynamic stable patients. This classification model will pave the way for future research concerning hemodynamic instability and its prevention.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-25DOI: 10.1213/ane.0000000000007309
Yan-Ying Xiao,Hai-Ding Zou,Xiu-Nan Qin,Rong Zhu,Ru-Ping Dai
BACKGROUNDIntraoperative hypotension is the most common adverse event in endoscopic retrograde cholangiopancreatography (ERCP) and is usually attributed to the vasodilatory effect of the anesthetic. The aim of this randomized controlled trial was to evaluate the impact of remimazolam versus propofol on blood pressure changes during the therapeutic ERCP procedure.METHODSAdult patients scheduled for elective therapeutic ERCP were randomized to receive either remimazolam or propofol anesthesia (40 patients in each group). The primary outcomes included the change in mean arterial pressure (MAP) during induction and the area under the baseline (AUB), calculated as the blood pressure below baseline multiplied by the duration, throughout the procedure. These measures, respectively, indicated the severity of blood pressure decrease during anesthesia induction and the overall impact of blood pressure changes throughout the procedure. Any incidences of hypotension, defined as MAP <65 mm Hg for at least 1 minute, were recorded. The recovery time and any adverse events were also reported.RESULTSThe change in MAP after induction was smaller in the remimazolam group compared to the propofol group (-7.5 [-14.0 to 0] mm Hg vs -25.0 [-33.8 to -14.3] mm Hg), with a median difference of 17.0 mm Hg (95% confidence interval [CI], 12.0-22.0; P <.001). The AUB in the remimazolam group was less than in the propofol group (-373 [-82 to -854] mm Hg·min vs -705 [-272 to -1100] mm Hg·min), with a median difference of 255 mm Hg·min (95% CI, 29-477; P =.021). The incidence of hypotension was significantly lower for remimazolam than propofol (5% vs 30%; P =.006). There were no serious adverse events in either group.CONCLUSIONSRemimazolam may be considered as an alternative to propofol for general anesthesia during therapeutic ERCP procedures, with the potential advantage of stable hemodynamics.
背景术中低血压是内镜逆行胰胆管造影术（ERCP）中最常见的不良反应，通常归因于麻醉剂的血管扩张作用。本随机对照试验的目的是评估治疗性ERCP过程中瑞马唑仑和异丙酚对血压变化的影响。方法将计划接受治疗性ERCP的成人患者随机分为两组，一组接受瑞马唑仑麻醉，另一组接受异丙酚麻醉（每组 40 名患者）。主要结果包括诱导过程中平均动脉压 (MAP) 的变化，以及整个手术过程中的基线下面积 (AUB)（计算方法为低于基线的血压乘以持续时间）。这些指标分别表示麻醉诱导期间血压下降的严重程度和整个手术过程中血压变化的总体影响。任何低血压发生率（定义为 MAP <65 mm Hg 持续至少 1 分钟）都会被记录下来。结果与异丙酚组相比，瑞马唑仑组诱导后的 MAP 变化较小（-7.5 [-14.0 to 0] mm Hg vs -25.0 [-33.8 to -14.3] mm Hg），中位差异为 17.0 mm Hg（95% 置信区间 [CI]，12.0-22.0；P <.001）。瑞马唑仑组的AUB低于异丙酚组（-373 [-82 to -854] mm Hg-min vs -705 [-272 to -1100] mm Hg-min），中位差值为255 mm Hg-min (95% CI, 29-477; P =.021)。瑞马唑仑的低血压发生率明显低于异丙酚（5% vs 30%；P =.006）。结论在治疗性ERCP手术中，瑞马唑仑可考虑作为异丙酚的替代品进行全身麻醉，其潜在优势是血流动力学稳定。
{"title":"A Comparison of Remimazolam versus Propofol on Blood Pressure Changes During Therapeutic Endoscopic Retrograde Cholangiopancreatography: A Randomized Controlled Trial.","authors":"Yan-Ying Xiao,Hai-Ding Zou,Xiu-Nan Qin,Rong Zhu,Ru-Ping Dai","doi":"10.1213/ane.0000000000007309","DOIUrl":"https://doi.org/10.1213/ane.0000000000007309","url":null,"abstract":"BACKGROUNDIntraoperative hypotension is the most common adverse event in endoscopic retrograde cholangiopancreatography (ERCP) and is usually attributed to the vasodilatory effect of the anesthetic. The aim of this randomized controlled trial was to evaluate the impact of remimazolam versus propofol on blood pressure changes during the therapeutic ERCP procedure.METHODSAdult patients scheduled for elective therapeutic ERCP were randomized to receive either remimazolam or propofol anesthesia (40 patients in each group). The primary outcomes included the change in mean arterial pressure (MAP) during induction and the area under the baseline (AUB), calculated as the blood pressure below baseline multiplied by the duration, throughout the procedure. These measures, respectively, indicated the severity of blood pressure decrease during anesthesia induction and the overall impact of blood pressure changes throughout the procedure. Any incidences of hypotension, defined as MAP <65 mm Hg for at least 1 minute, were recorded. The recovery time and any adverse events were also reported.RESULTSThe change in MAP after induction was smaller in the remimazolam group compared to the propofol group (-7.5 [-14.0 to 0] mm Hg vs -25.0 [-33.8 to -14.3] mm Hg), with a median difference of 17.0 mm Hg (95% confidence interval [CI], 12.0-22.0; P <.001). The AUB in the remimazolam group was less than in the propofol group (-373 [-82 to -854] mm Hg·min vs -705 [-272 to -1100] mm Hg·min), with a median difference of 255 mm Hg·min (95% CI, 29-477; P =.021). The incidence of hypotension was significantly lower for remimazolam than propofol (5% vs 30%; P =.006). There were no serious adverse events in either group.CONCLUSIONSRemimazolam may be considered as an alternative to propofol for general anesthesia during therapeutic ERCP procedures, with the potential advantage of stable hemodynamics.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"96 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xenon and argon are currently being evaluated as potential neuroprotective treatments for acquired brain injuries. Xenon has been evaluated clinically as a treatment for brain ischemia with equivocal results in small trials, but argon has not yet undergone clinical evaluation. Several preclinical studies have investigated xenon or argon as treatments in animal models of perinatal hypoxic-ischemic encephalopathy (HIE). A systematic review of MEDLINE and Embase databases was performed. After screening of titles, abstracts, and full text, data were extracted from included studies. A pairwise meta-analysis of neuroprotective efficacy was performed using a random effects model. Heterogeneity was investigated using subgroup analysis, funnel plot asymmetry, and Egger's regression. The protocol was prospectively registered on PROSPERO (CRD42022301986). A total of 21 studies met the inclusion criteria. The data extracted included measurements from 1591 animals, involving models of HIE in mice, rats, and pigs. The meta-analysis found that both xenon and argon had significant (P < .0001) neuroprotective efficacies. The summary estimate for xenon was 39.7% (95% confidence interval [CI], 28.3%-51.1%) and for argon it was 70.3% (95% CI, 59.0%-81.7%). The summary effect for argon was significantly (P < .001) greater than that of xenon. Our results provide evidence supporting further investigation of xenon and argon as neuroprotective treatments for HIE.
{"title":"Xenon and Argon as Neuroprotective Treatments for Perinatal Hypoxic-Ischemic Brain Injury: A Preclinical Systematic Review and Meta-Analysis.","authors":"Mariana Barros,Min Liang,Noemi Iannucci,Robert Dickinson","doi":"10.1213/ane.0000000000007223","DOIUrl":"https://doi.org/10.1213/ane.0000000000007223","url":null,"abstract":"Xenon and argon are currently being evaluated as potential neuroprotective treatments for acquired brain injuries. Xenon has been evaluated clinically as a treatment for brain ischemia with equivocal results in small trials, but argon has not yet undergone clinical evaluation. Several preclinical studies have investigated xenon or argon as treatments in animal models of perinatal hypoxic-ischemic encephalopathy (HIE). A systematic review of MEDLINE and Embase databases was performed. After screening of titles, abstracts, and full text, data were extracted from included studies. A pairwise meta-analysis of neuroprotective efficacy was performed using a random effects model. Heterogeneity was investigated using subgroup analysis, funnel plot asymmetry, and Egger's regression. The protocol was prospectively registered on PROSPERO (CRD42022301986). A total of 21 studies met the inclusion criteria. The data extracted included measurements from 1591 animals, involving models of HIE in mice, rats, and pigs. The meta-analysis found that both xenon and argon had significant (P < .0001) neuroprotective efficacies. The summary estimate for xenon was 39.7% (95% confidence interval [CI], 28.3%-51.1%) and for argon it was 70.3% (95% CI, 59.0%-81.7%). The summary effect for argon was significantly (P < .001) greater than that of xenon. Our results provide evidence supporting further investigation of xenon and argon as neuroprotective treatments for HIE.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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