Myocardial Blood Flow during General Anesthesia with Xenon in Humans

Abstract

Background: Xenon has only minimal hemodynamic side effects and induces pharmacologic preconditioning. Thus, the use of xenon could be an interesting option in patients at risk for perioperative myocardial ischemia. However, little is known about the effects of xenon anesthesia on myocardial blood flow (MBF) and coronary vascular resistance in humans. Methods: Myocardial blood flow was noninvasively quantified by H 2 15 O positron emission tomography in six healthy volunteers (age: 38 Ϯ 8 yr). MBF was measured at baseline and during general anesthesia induced with propofol and maintained with xenon, 59 Ϯ 0%. Absolute quantification

Xenon anaesthesia for patients undergoing off-pump coronary artery bypass graft surgery: a prospective randomized controlled pilot trial

“…3 4 Such haemodynamic effects may result in an overall improvement of the balance between myocardial oxygen delivery and consumption. Moreover, xenon is virtually devoid of negative inotropic effects, 5 preserves myocardial blood flow, 6 improves recovery from post-ischaemic contractile dysfunction, 7 and limits adverse remodelling after perioperative myocardial infarction. 8 As the course of off-pump coronary artery bypass (OPCAB) surgery entails significant haemodynamic alterations, OPCAB patients carry a high-risk for perioperative myocardial ischaemia and perioperative haemodynamic instability.…”

Feasibility and safety of xenon compared with sevoflurane anaesthesia in coronary surgical patients: a randomized controlled pilot study

“…Maintenance fluid requirements were provided with 1 ml kg 21 h 21 balanced crystalloid solutions. Packed red blood cells were transfused when the haemoglobin content was below 7.5 g dl 21 . Epinephrine was used for inotropic support and norepinephrine was administered when haemodynamic stabilization could not be achieved with adequate fluid replacement.…”

“…18 -20 Of note, xenon has been recently shown in human volunteers not to affect myocardial blood flow and to preserve flow metabolism coupling within the myocardium. 21 The combination of a favourable haemodynamic profile, with cardio-and neuroprotective properties, makes xenon an attractive option for the anaesthesia of patients undergoing coronary artery bypass grafting (CABG).…”

Noble gases as cardioprotectants – translatability and mechanism

“…Xenon has virtually no direct influence on myocardial blood flow and global haemodynamics in healthy and diseased hearts (Preckel et al ., 2002a,b). Therefore, the use of xenon has been advocated in cardiac‐compromised patients (Baumert et al ., 2005; 2008; Bein et al ., ), and several studies have demonstrated intraoperative preservation of myocardial contractility and stable haemodynamics (Coburn et al ., ; Wappler et al ., ; Schaefer et al ., ). Despite the huge amount of experimental studies on xenon conditioning of the heart (Preckel et al ., ) and neuronal tissue (Deng et al ., ), there are, as yet, no studies clearly translating the conditioning properties of xenon found in experimental studies to humans.…”