Article Text

PDF

Xenon offers stable haemodynamics after global hypoxic-ischaemia in newborn pigs
  1. E Chakkarapani1,
  2. X Liu1,
  3. J Dingley2,
  4. M Thoresen1
  1. 1University of Bristol, Bristol, UK
  2. 2Swansea University, Swansea, UK

Abstract

Background Perinatal hypoxic ischaemic encephalopathy (HIE) causes cardiac dysfunction/hypotension. Xenon (Xe) anaesthesia offers short term stable haemodynamics in human adults/mature animals with cardiovascular risk. We studied long term haemodynamics during 50% xenon inhalation at normothermia (NT 38.5°C) or hypothermia (HT 33.5°C) in a newborn global Hypoxic-Ischaemic (HI) pig model.

Methods 98 newborn pigs were ventilated under inhalational anaesthesia, given a 45 min global HI insult (inhaled oxygen fraction reduced until amplitude integrated electroencephalogram <7 µV), then randomised to three xenon (50%Xe with NT18 h (h), HT12 h or HT24 h) or three non-xenon groups (NT, HT12 h or HT24 h) with intravenous anaesthesia. Mean arterial blood pressure (MABP) was measured every minute. Hypotension (<40 mm Hg for >10 min) was treated sequentially with 2×10 ml/kg saline, dopamine, norepinephrine, hydrocortisone if required.

Results Xenon maintained a higher MABP than in non-xenon groups; 4.5 mm Hg (95% CI 2.4 to 6.7) during Xe-inhalation and 4.1 mm Hg (95% CI 0.37 to 7.8) post-Xe therapy. Duration of inotropic support was reduced by 6.6 h (95%CI 3.5 to 9.8) during Xe-inhalation and by 7.9 h (95%CI 0.5 to 15.3) post-Xe therapy. Xe-inhalation during rewarming maintained higher MABP by 15.4 mm Hg, 95% CI 10.3 to 20.4. Xenon when combined with HT cleared lactate 3 h faster post-HI ((XeHT) 2.86 mmol (0, 14.7) vs (HT) 5.96 mmol/l (1.7, 13.8), p=0.0004). Hypothermia reduced heart rate by 10 beats/min (bpm)/°C; adding dopamine decreased this reduction to 7 bpm/°C.

Conclusion Xenon reduced post-HI inotropic support requirements during and after administration, independent of temperature. Xenon may offer haemodynamic benefits when used in clinical neuroprotection studies by reducing HI induced hypotension.

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.