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A preclinical systematic review and meta-analysis of the noble gases argon and xenon as treatments for acquired brain injury

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Title: A preclinical systematic review and meta-analysis of the noble gases argon and xenon as treatments for acquired brain injury
Authors: Liang, M
Ahmad, F
Dickinson, R
Item Type: Journal Article
Abstract: Background The noble gases argon and xenon are potential novel neuroprotective treatments for acquired brain injuries. Xenon has already undergone early-stage clinical trials in the treatment of ischaemic brain injuries, with mixed results. Argon has yet to progress to clinical trials as a treatment for brain injury. Here, we aim to synthesise the results of preclinical studies evaluating argon and xenon as neuroprotective therapies for brain injuries. Methods After a systematic review of the MEDLINE and Embase databases, we carried out a pairwise and stratified meta-analysis. Heterogeneity was examined by subgroup analysis, funnel plot asymmetry, and Egger's regression. Results A total of 32 studies were identified, 14 for argon and 18 for xenon, involving measurements from 1384 animals, including murine, rat, and porcine models. Brain injury models included ischaemic brain injury after cardiac arrest (CA), neurological injury after cardiopulmonary bypass (CPB), traumatic brain injury (TBI), and ischaemic stroke. Both argon and xenon had significant (P<0.001), positive neuroprotective effect sizes. The overall effect size for argon (CA, TBI, stroke) was 18.1% (95% confidence interval [CI], 8.1–28.1%), and for xenon (CA, TBI, stroke) was 34.1% (95% CI, 24.7–43.6%). Including the CPB model, only present for xenon, the xenon effect size (CPB, CA, TBI, stroke) was 27.4% (95% CI, 11.5–43.3%). Xenon, both with and without the CPB model, was significantly (P<0.001) more protective than argon. Conclusions These findings provide evidence to support the use of xenon and argon as neuroprotective treatments for acquired brain injuries. Current evidence suggests that xenon is more efficacious than argon overall.
Issue Date: Aug-2022
Date of Acceptance: 12-Apr-2022
URI: http://hdl.handle.net/10044/1/97064
DOI: 10.1016/j.bja.2022.04.016
ISSN: 0007-0912
Publisher: Elsevier
Start Page: 200
End Page: 218
Journal / Book Title: British Journal of Anaesthesia
Volume: 129
Issue: 2
Copyright Statement: © 2022 The Authors. Published by Elsevier Ltd on behalf of British Journal of Anaesthesia. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/).
Sponsor/Funder: Royal Centre for Defence Medicine
Medical Research Council (MRC)
Funder's Grant Number: 20120229-DMSRASG/Xenon
MR/N027736/1
Keywords: animal models
cardiac arrest
cardiopulmonary bypass
inert gases
ischaemic brain injury
ischaemic stroke
neuroprotection
traumatic brain injury
Animals
Argon
Brain Injuries
Brain Ischemia
Heart Arrest
Mice
Neuroprotection
Neuroprotective Agents
Noble Gases
Rats
Stroke
Swine
Xenon
Animals
Swine
Mice
Rats
Brain Injuries
Brain Ischemia
Heart Arrest
Noble Gases
Argon
Xenon
Neuroprotective Agents
Stroke
Neuroprotection
Anesthesiology
1103 Clinical Sciences
Publication Status: Published
Online Publication Date: 2022-06-07
Appears in Collections:Department of Metabolism, Digestion and Reproduction
Department of Surgery and Cancer
Faculty of Medicine



This item is licensed under a Creative Commons License Creative Commons