Barros Mariana, Liang Min, Iannucci Noemi, Dickinson Robert
From the Anaesthetics, Pain Medicine and Intensive Care Division, Department of Surgery and Cancer, Imperial College London, London, United Kingdom.
Anaesthesiology Research Institute, Department of Anaesthesiology, First Affiliated Hospital of Fujian Medical University, Binhai Campus, Fuzhou, China.
Anesth Analg. 2024 Oct 25. doi: 10.1213/ANE.0000000000007223.
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.
目前正在评估氙气和氩气作为获得性脑损伤潜在神经保护治疗方法的可能性。氙气已在临床上作为脑缺血的治疗方法进行评估，在小型试验中结果不明确，但氩气尚未进行临床评估。几项临床前研究已在围产期缺氧缺血性脑病（HIE）动物模型中研究了氙气或氩气作为治疗方法。对MEDLINE和Embase数据库进行了系统综述。在筛选标题、摘要和全文后，从纳入研究中提取数据。使用随机效应模型对神经保护疗效进行了成对荟萃分析。使用亚组分析、漏斗图不对称性和Egger回归研究异质性。该方案已在PROSPERO（CRD42022301986）上进行了前瞻性注册。共有21项研究符合纳入标准。提取的数据包括来自1591只动物的测量值，涉及小鼠、大鼠和猪的HIE模型。荟萃分析发现，氙气和氩气均具有显著（P <.0001）的神经保护疗效。氙气的汇总估计值为39.7%（95%置信区间[CI]，28.3%-51.1%），氩气的汇总估计值为70.3%（95%CI，59.0%-81.7%）。氩气的汇总效应显著（P <.001）大于氙气。我们的结果提供了证据，支持进一步研究氙气和氩气作为HIE的神经保护治疗方法。
