The Efficacy of Noble Gases in the Attenuation of Ischemia Reperfusion Injury: A Systematic Review and Meta-Analyses

Abstract

Helium and xenon show organ protective effects mostly in small animal ischemia reperfusion injury models. Additional information on timing, dosing, and comparative efficacy of the different noble gases, as well as confirmation in large animal models, is needed before designing clinical trials.

Postconditioning effects of argon or xenon on early graft function in a porcine model of kidney autotransplantation

“…The exact mechanisms underlying noble gas‐induced organ protection remain largely obscure, but most likely involve anti‐inflammatory and prosurvival mechanisms. As an example, xenon has been demonstrated to activate HIF‐1α and its downstream effectors, including erythropoietin and VEGF, in rodents.…”

“…These differences could suggest that noble gases might have different molecular effects in small and large animals that might have contributed to the lack of clinical effects of argon and xenon in this model. Indeed, only a few studies have examined the effects of these noble gases in large‐animal models, and found the organ‐protective effects of noble gases to be less obvious in large compared with small animals. Moreover, reported results in pigs are contradictory.…”

“…Noble gases, via anti‐inflammatory and prosurvival mechanisms, are believed to convey organ‐protective effects during IRI in a wide variety of medical conditions, including acute kidney injury and renal transplantation. A meta‐analysis confirmed that inhalation of xenon attenuated IRI and prolonged survival in rodent models of renal IRI and renal transplantation. Saturation of organ preservation solutions with argon had renoprotective effects in transplant models.…”

“…Saturation of organ preservation solutions with argon had renoprotective effects in transplant models. However, the results from large‐animal models have been disappointing, stressing the importance of performing well designed large‐animal studies before considering clinical trials.…”

Xenon as an adjuvant to sevoflurane anesthesia in children younger than 4 years of age, undergoing interventional or diagnostic cardiac catheterization: A randomized controlled clinical trial

“…Xenon has been demonstrated to have only minimal hemodynamic side effects when compared to commonly used intravenous or inhalational anesthetics . Moreover, xenon conveys neuroprotection in preclinical models of neonatal asphyxia and anesthesia‐induced neurotoxicity …”