Xenon and Argon as Neuroprotective Treatments for Perinatal Hypoxic-Ischemic Brain Injury: A Preclinical Systematic Review and Meta-Analysis.

Anesthesia & Analgesia Pub Date : 2024-10-25 DOI:10.1213/ane.0000000000007223

Mariana Barros,Min Liang,Noemi Iannucci,Robert Dickinson

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Abstract

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.

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氙和氩作为围产期缺氧缺血性脑损伤的神经保护疗法：临床前系统回顾和元分析》。

氙和氩目前正被评估为治疗后天性脑损伤的潜在神经保护疗法。氙已作为治疗脑缺血的药物进行了临床评估，但在小规模试验中效果不明显，而氩尚未进行临床评估。有几项临床前研究调查了氙或氩作为围产期缺氧缺血性脑病（HIE）动物模型的治疗方法。我们对 MEDLINE 和 Embase 数据库进行了系统性回顾。在对标题、摘要和全文进行筛选后，从纳入的研究中提取了数据。采用随机效应模型对神经保护功效进行了配对荟萃分析。采用亚组分析、漏斗图不对称和埃格回归法对异质性进行了研究。研究方案已在 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 1591 只动物的测量结果，涉及小鼠、大鼠和猪的 HIE 模型。荟萃分析发现，氙气和氩气都具有显著的神经保护功效（P < .0001）。氙的综合估计值为 39.7%（95% 置信区间 [CI]，28.3%-51.1%），氩的综合估计值为 70.3%（95% 置信区间，59.0%-81.7%）。氩气的综合效应明显高于氙气（P < .001）。我们的研究结果为进一步研究氙和氩作为 HIE 神经保护疗法提供了证据支持。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Anesthesia & Analgesia

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