Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19106, USA,
Transl Stroke Res. 2012 Sep;3(3):375-80. doi: 10.1007/s12975-012-0183-8. Epub 2012 Jun 15.
Despite more than 30 years of clinical use, questions remain about the safety of xenon gas in Xenon-CT cerebral blood flow (XeCTCBF) studies. In particular, xenon's effect on brain oxygen (PbtO2) in comatose patients is not well defined. Our objective was to assess the effect of a 4.5-min inhalation of 28 % stable xenon on several physiologic variables, including intracranial pressure (ICP), cerebral perfusion pressure (CPP), and PbtO2 in comatose patients (Glasgow Coma Scale [GCS] ≤ 8). Thirty-seven comatose patients who underwent 73 XeCTCBF studies were identified retrospectively from a prospective observational database. Changes in MAP, HR, SaO2, EtCO2, ICP, CPP, and PbtO2 measured at the start of xenon administration and every minute for 5 min thereafter were assessed. The maximum change in each variable also was determined for each scan to tabulate clinically relevant changes. Statistically, but not clinically significant changes in MAP, HR, and EtCO2 were seen. Xenon had no effect on ICP, and a small, but clinically insignificant decrease in CPP and PbtO2, was observed. There was a varied response to xenon in most measured variables. Clinically significant changes in each were infrequent, and readily reversed with the cessation of the gas. We conclude that xenon does not appear to have a clinically significant effect on ICP, CPP, and PbtO2 and so appears safe to evaluate cerebral blood flow in comatose patients.
尽管氙气在 Xenon-CT 脑血流（XeCTCBF）研究中已经有 30 多年的临床应用，但关于其安全性的问题仍然存在。特别是，昏迷患者中氙气对脑氧（PbtO2）的影响还没有得到很好的定义。我们的目的是评估 4.5 分钟吸入 28%稳定氙气对几种生理变量的影响，包括颅内压（ICP）、脑灌注压（CPP）和昏迷患者的 PbtO2（格拉斯哥昏迷量表[GCS]≤8）。从一个前瞻性观察数据库中回顾性地确定了 37 名接受 73 次 XeCTCBF 研究的昏迷患者。评估了氙气给药开始时和此后每分钟测量的 MAP、HR、SaO2、EtCO2、ICP、CPP 和 PbtO2 的变化。还为每个扫描确定了每个变量的最大变化，以列出有临床意义的变化。统计学上，但不是临床上显著的 MAP、HR 和 EtCO2 变化。氙气对 ICP 没有影响，观察到 CPP 和 PbtO2 略有下降，但临床意义不大。在大多数测量变量中，氙气的反应各不相同。每个变量的临床显著变化都很少见，并且随着气体的停止很容易逆转。我们的结论是，氙气似乎对 ICP、CPP 和 PbtO2 没有明显的临床影响，因此在评估昏迷患者的脑血流时似乎是安全的。
