Robel Richie, Caroccio Peter, Maze Mervyn
NeuroproteXeon, Orchard Park, NY, United States.
University of California San Francisco, San Francisco, CA, United States.
Methods Enzymol. 2018;602:273-288. doi: 10.1016/bs.mie.2018.01.010. Epub 2018 Feb 27.
Xenon has features that make it an ideal general anesthetic agent; cost and scarcity mitigate xenon's widespread use in the operating room. Discovery of xenon's cytoprotective properties resulted in its application to thwart ongoing acute neurologic injury, an unmet clinical need. The discovery that xenon's neuroprotective effect interacts synergistically with targeted temperature management (TTM) led to its investigation in clinical settings, including in the management of the postcardiac arrest syndrome, in which TTM is indicated. Following successful demonstration of xenon's efficacy in combination with TTM in a preclinical model of porcine cardiac arrest, xenon plus TTM was shown to significantly decrease an imaging biomarker of brain injury for out of hospital cardiac arrest victims that had been successfully resuscitated. With the development of an efficient delivery system the stage is now set to investigate whether xenon improves survival, with good clinical outcome, for successfully resuscitated victims of a cardiac arrest.
氙具有使其成为理想的全身麻醉剂的特性;成本和稀缺性限制了氙在手术室中的广泛应用。氙的细胞保护特性的发现促使其被应用于预防持续的急性神经损伤,这是一个尚未满足的临床需求。氙的神经保护作用与目标温度管理(TTM)协同作用的发现促使其在临床环境中进行研究,包括在心搏骤停综合征的管理中,其中TTM是适用的。在猪心搏骤停的临床前模型中成功证明氙与TTM联合使用的疗效后,氙加TTM被证明可显著降低已成功复苏的院外心搏骤停受害者脑损伤的成像生物标志物。随着高效输送系统的开发,现在已具备研究氙是否能提高成功复苏的心搏骤停受害者的生存率并带来良好临床结果的条件。