title: Safety and feasibility of xenon as an adjuvant to sevoflurane anaesthesia in children undergoing interventional or diagnostic cardiac catheterization: study protocol for a randomised controlled trial.
abstract: BACKGROUND
  Xenon has minimal haemodynamic side effects when compared to volatile or intravenous anaesthetics. Moreover, in in vitro and in animal experiments, xenon has been demonstrated to convey cardio- and neuroprotective effects. Neuroprotection could be advantageous in paediatric anaesthesia as there is growing concern, based on both laboratory studies and retrospective human clinical studies, that anaesthetics may trigger an injury in the developing brain, resulting in long-lasting neurodevelopmental consequences. Furthermore, xenon-mediated neuroprotection could help to prevent emergence delirium/agitation. Altogether, the beneficial haemodynamic profile combined with its putative organ-protective properties could render xenon an attractive option for anaesthesia of children undergoing cardiac catheterization.
  
  
  METHODS
  In a phase-II, mono-centre, prospective, single-blind, randomised, controlled study, we will test the hypothesis that the administration of 50% xenon as an adjuvant to general anaesthesia with sevoflurane in children undergoing elective cardiac catheterization is safe and feasible. Secondary aims include the evaluation of haemodynamic parameters during and after the procedure, emergence characteristics, and the analysis of peri-operative neuro-cognitive function. A total of 40 children ages 4 to 12 years will be recruited and randomised into two study groups, receiving either a combination of sevoflurane and xenon or sevoflurane alone.
  
  
  CONCLUSIONS
  Children undergoing diagnostic or interventional cardiac catheterization are a vulnerable patient population, one particularly at risk for intra-procedural haemodynamic instability. Xenon provides remarkable haemodynamic stability and potentially has cardio- and neuroprotective properties. Unfortunately, evidence is scarce on the use of xenon in the paediatric population. Our pilot study will therefore deliver important data required for prospective future clinical trials.
  
  
  BACKGROUND
  EudraCT: 2014-002510-23 (5 September 2014).
authors.affiliation: Department of Anaesthesiology, University Hospitals of the KU Leuven, Herestraat 49, 3000, Leuven, Belgium. sarah.devroe@uzleuven.be.
authors.forename: Sarah
authors.initials: S
authors.lastname: Devroe
authors.affiliation: Department of Child and Adolescent Psychiatry, University Hospitals of the KU Leuven, Herestraat 49, 3000, Leuven, Belgium. jurgen.lemiere@uzleuven.be.|Department of Paediatric Haemato-Oncology, University Hospitals of the KU Leuven, Herestraat 49, 3000, Leuven, Belgium. jurgen.lemiere@uzleuven.be.
authors.forename: Jurgen
authors.initials: J
authors.lastname: Lemiere
authors.affiliation: Department of Anaesthesiology, University Hospitals of the KU Leuven, Herestraat 49, 3000, Leuven, Belgium. marc.vandevelde@uzleuven.be.|Department of Cardiovascular Sciences, KU Leuven, Herestraat 49, 3000, Leuven, Belgium. marc.vandevelde@uzleuven.be.
authors.forename: Marc
authors.initials: M
authors.lastname: Van de Velde
authors.affiliation: Department of Paediatric and Congenital Cardiology, University Hospitals of the KU Leuven, Herestraat 49, 3000, Leuven, Belgium. marc.gewillig@uzleuven.be.
authors.forename: Marc
authors.initials: M
authors.lastname: Gewillig
authors.affiliation: Department of Paediatric and Congenital Cardiology, University Hospitals of the KU Leuven, Herestraat 49, 3000, Leuven, Belgium. derize.boshoff@uzleuven.be.
authors.forename: Derize
authors.initials: D
authors.lastname: Boshoff
authors.affiliation: Department of Anaesthesiology, University Hospitals of the KU Leuven, Herestraat 49, 3000, Leuven, Belgium. steffen.rex@uzleuven.be.|Department of Cardiovascular Sciences, KU Leuven, Herestraat 49, 3000, Leuven, Belgium. steffen.rex@uzleuven.be.
authors.forename: Steffen
authors.initials: S
authors.lastname: Rex
mesh_terms: D000759:Adjuvants, Anesthesia / Q000494:pharmacology*; D006328:Cardiac Catheterization; D002648:Child; D002985:Clinical Protocols; D005240:Feasibility Studies; D006801:Humans; D008738:Methyl Ethers / Q000494:pharmacology*; D011446:Prospective Studies; D000077149:Sevoflurane; D016037:Single-Blind Method; D014978:Xenon / Q000009:adverse effects / Q000494:pharmacology*
chemical_list: D000759:Adjuvants, Anesthesia; D008738:Methyl Ethers; D000077149:Sevoflurane; D014978:Xenon