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Use of xenon as a sedative for patients receiving critical care.

John Dingley

Crit Care Med, Volume: 31, Issue: 10, Pages: 2470 - 2477

Swansea University Author: John Dingley

Abstract

OBJECTIVE:Many sedative regimens are used in the intensive care setting, but none are wholly without adverse effect. Xenon is a noble gas with sedative and analgesic properties. It has been used successfully as a general anesthetic and has many desirable properties, not least of which is a minimal e...

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Published in: Crit Care Med
Published: 2003
URI: https://cronfa.swan.ac.uk/Record/cronfa27499
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2016-04-27T22:00:12.1926654</datestamp><bib-version>v2</bib-version><id>27499</id><entry>2016-04-27</entry><title>Use of xenon as a sedative for patients receiving critical care.</title><swanseaauthors><author><sid>1283ffdd09b091ec57ec3e235a48cfcc</sid><firstname>John</firstname><surname>Dingley</surname><name>John Dingley</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2016-04-27</date><deptcode>PMSC</deptcode><abstract>OBJECTIVE:Many sedative regimens are used in the intensive care setting, but none are wholly without adverse effect. Xenon is a noble gas with sedative and analgesic properties. It has been used successfully as a general anesthetic and has many desirable properties, not least of which is a minimal effect on the myocardium. In theory, xenon may provide sedation without adverse effect for certain groups of critically ill patients. The objective of this study was to assess the feasibility of using xenon as an intensive care sedative.DESIGN:Double-blind, randomized study.SETTING:Tertiary-level intensive care unit.SUBJECTS:Twenty-one patients admitted to an intensive care unit following elective thoracic surgery.INTERVENTIONS:A standard intensive care sedation regimen (intravenous propofol at 0-5 mg.kg-1.hr-1 and alfentanil 30 microg.kg-1.hr-1) was compared with a xenon sedation regimen delivered using a novel bellows-in-bottle delivery system. MEASUREMENTS AND MAIN RESULTS Each sedative regimen was continued for 8 hrs. The hemodynamic effects, additional analgesic requirements, recovery from sedation, and effect on hematological and biochemical variables were compared for the two sedation regimens. All patients were successfully sedated during the xenon regimen. The mean +/- SD end-tidal xenon concentration required to provide sedation throughout the duration of the study was 28 +/- 9.0% (range, 9-62%). Arterial systolic, diastolic, and mean pressures showed a greater tendency for negative gradients in patients receiving the propofol regimen (p &lt;.05, p &lt;.1, and p &lt;.01, respectively). Recovery following xenon was significantly faster than from the standard sedation regimen (p &lt;.0001). Hematological and biochemical laboratory markers were within normal clinical limits in both groups.CONCLUSIONS:Xenon provided satisfactory sedation in our group of patients. It was well tolerated with minimal hemodynamic effect. Recovery from this agent is extremely rapid. We have demonstrated the feasibility of using xenon within the critical care setting, without adverse effect.</abstract><type>Journal Article</type><journal>Crit Care Med</journal><volume>31</volume><journalNumber>10</journalNumber><paginationStart>2470</paginationStart><paginationEnd>2477</paginationEnd><publisher/><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint/><issnElectronic/><keywords/><publishedDay>31</publishedDay><publishedMonth>10</publishedMonth><publishedYear>2003</publishedYear><publishedDate>2003-10-31</publishedDate><doi/><url/><notes/><college>COLLEGE NANME</college><department>Medicine</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>PMSC</DepartmentCode><institution>Swansea University</institution><apcterm/><lastEdited>2016-04-27T22:00:12.1926654</lastEdited><Created>2016-04-27T22:00:12.1926654</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>John</firstname><surname>Dingley</surname><order>1</order></author></authors><documents/><OutputDurs/></rfc1807>
spelling 2016-04-27T22:00:12.1926654 v2 27499 2016-04-27 Use of xenon as a sedative for patients receiving critical care. 1283ffdd09b091ec57ec3e235a48cfcc John Dingley John Dingley true false 2016-04-27 PMSC OBJECTIVE:Many sedative regimens are used in the intensive care setting, but none are wholly without adverse effect. Xenon is a noble gas with sedative and analgesic properties. It has been used successfully as a general anesthetic and has many desirable properties, not least of which is a minimal effect on the myocardium. In theory, xenon may provide sedation without adverse effect for certain groups of critically ill patients. The objective of this study was to assess the feasibility of using xenon as an intensive care sedative.DESIGN:Double-blind, randomized study.SETTING:Tertiary-level intensive care unit.SUBJECTS:Twenty-one patients admitted to an intensive care unit following elective thoracic surgery.INTERVENTIONS:A standard intensive care sedation regimen (intravenous propofol at 0-5 mg.kg-1.hr-1 and alfentanil 30 microg.kg-1.hr-1) was compared with a xenon sedation regimen delivered using a novel bellows-in-bottle delivery system. MEASUREMENTS AND MAIN RESULTS Each sedative regimen was continued for 8 hrs. The hemodynamic effects, additional analgesic requirements, recovery from sedation, and effect on hematological and biochemical variables were compared for the two sedation regimens. All patients were successfully sedated during the xenon regimen. The mean +/- SD end-tidal xenon concentration required to provide sedation throughout the duration of the study was 28 +/- 9.0% (range, 9-62%). Arterial systolic, diastolic, and mean pressures showed a greater tendency for negative gradients in patients receiving the propofol regimen (p <.05, p <.1, and p <.01, respectively). Recovery following xenon was significantly faster than from the standard sedation regimen (p <.0001). Hematological and biochemical laboratory markers were within normal clinical limits in both groups.CONCLUSIONS:Xenon provided satisfactory sedation in our group of patients. It was well tolerated with minimal hemodynamic effect. Recovery from this agent is extremely rapid. We have demonstrated the feasibility of using xenon within the critical care setting, without adverse effect. Journal Article Crit Care Med 31 10 2470 2477 31 10 2003 2003-10-31 COLLEGE NANME Medicine COLLEGE CODE PMSC Swansea University 2016-04-27T22:00:12.1926654 2016-04-27T22:00:12.1926654 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine John Dingley 1
title Use of xenon as a sedative for patients receiving critical care.
spellingShingle Use of xenon as a sedative for patients receiving critical care.
John Dingley
title_short Use of xenon as a sedative for patients receiving critical care.
title_full Use of xenon as a sedative for patients receiving critical care.
title_fullStr Use of xenon as a sedative for patients receiving critical care.
title_full_unstemmed Use of xenon as a sedative for patients receiving critical care.
title_sort Use of xenon as a sedative for patients receiving critical care.
author_id_str_mv 1283ffdd09b091ec57ec3e235a48cfcc
author_id_fullname_str_mv 1283ffdd09b091ec57ec3e235a48cfcc_***_John Dingley
author John Dingley
author2 John Dingley
format Journal article
container_title Crit Care Med
container_volume 31
container_issue 10
container_start_page 2470
publishDate 2003
institution Swansea University
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 0
active_str 0
description OBJECTIVE:Many sedative regimens are used in the intensive care setting, but none are wholly without adverse effect. Xenon is a noble gas with sedative and analgesic properties. It has been used successfully as a general anesthetic and has many desirable properties, not least of which is a minimal effect on the myocardium. In theory, xenon may provide sedation without adverse effect for certain groups of critically ill patients. The objective of this study was to assess the feasibility of using xenon as an intensive care sedative.DESIGN:Double-blind, randomized study.SETTING:Tertiary-level intensive care unit.SUBJECTS:Twenty-one patients admitted to an intensive care unit following elective thoracic surgery.INTERVENTIONS:A standard intensive care sedation regimen (intravenous propofol at 0-5 mg.kg-1.hr-1 and alfentanil 30 microg.kg-1.hr-1) was compared with a xenon sedation regimen delivered using a novel bellows-in-bottle delivery system. MEASUREMENTS AND MAIN RESULTS Each sedative regimen was continued for 8 hrs. The hemodynamic effects, additional analgesic requirements, recovery from sedation, and effect on hematological and biochemical variables were compared for the two sedation regimens. All patients were successfully sedated during the xenon regimen. The mean +/- SD end-tidal xenon concentration required to provide sedation throughout the duration of the study was 28 +/- 9.0% (range, 9-62%). Arterial systolic, diastolic, and mean pressures showed a greater tendency for negative gradients in patients receiving the propofol regimen (p <.05, p <.1, and p <.01, respectively). Recovery following xenon was significantly faster than from the standard sedation regimen (p <.0001). Hematological and biochemical laboratory markers were within normal clinical limits in both groups.CONCLUSIONS:Xenon provided satisfactory sedation in our group of patients. It was well tolerated with minimal hemodynamic effect. Recovery from this agent is extremely rapid. We have demonstrated the feasibility of using xenon within the critical care setting, without adverse effect.
published_date 2003-10-31T03:33:20Z
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score 11.012678

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