TY - JOUR
T1 - Physiologic Effects of Xenon in Xenon-CT Cerebral Blood Flow Studies on Comatose Patients
AU - Kosty, J. A.
AU - Kofke, W. A.
AU - Maloney-Wilensky, E.
AU - Frangos, S. G.
AU - Levine, J. M.
AU - LeRoux, P. D.
AU - Zager, E. L.
N1 - Funding Information:
Acknowledgments We acknowledge the valuable contributions of the nurses in the NeuroIntensive Care Unit at the Hospital of the University of Pennsylvania who cared for these patients and the staff of the Neurosurgery Clinical Research Division who collected the research data. This research was supported in part by research grants from the Integra Foundation (PDLR), and the Mary Elisabeth Groff Surgical and Medical Research Trust (PDLR). PDLR was a member of Integra’s Speaker’s Bureau.
PY - 2012/9
Y1 - 2012/9
N2 - 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.
AB - 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.
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U2 - 10.1007/s12975-012-0183-8
DO - 10.1007/s12975-012-0183-8
M3 - Article
AN - SCOPUS:84865788675
SN - 1868-4483
VL - 3
SP - 375
EP - 380
JO - Translational Stroke Research
JF - Translational Stroke Research
IS - 3
ER -