Preclinical neuroprotective actions of xenon and possible implications for human therapeutics: a narrative review.
OBJECTIVE
The purpose of this report is to facilitate an understanding of the possible application of xenon for neuroprotection in critical care settings. This narrative review appraises the literature assessing the efficacy and safety of xenon in preclinical models of acute ongoing neurologic injury.


METHODS
Databases of the published literature (MEDLINE® and EMBASE™) were appraised for peer-reviewed manuscripts addressing the use of xenon in both preclinical models and disease states of acute ongoing neurologic injury. For randomized clinical trials not yet reported, the investigators' declarations in the National Institutes of Health clinical trials website were considered.


RESULTS
While not a primary focus of this review, to date, xenon cannot be distinguished as superior for surgical anesthesia over existing alternatives in adults. Nevertheless, studies in a variety of preclinical disease models from multiple laboratories have consistently shown xenon's neuroprotective properties. These properties are enhanced in settings where xenon is combined with hypothermia. Small randomized clinical trials are underway to explore xenon's efficacy and safety in clinical settings of acute neurologic injury where hypothermia is the current standard of care.


CONCLUSIONS
According to the evidence to date, the neuroprotective efficacy of xenon in preclinical models and its safety in clinical anesthesia set the stage for the launch of randomized clinical trials to determine whether these encouraging neuroprotective findings can be translated into clinical utility.
Department of Anesthesia and Perioperative Care, University of California, San Francisco, 1001 Potrero Avenue, Box 1363, San Francisco, CA, 94110, USA. mervyn.maze@ucsf.edu.
Mervyn
M
Maze
D000328:Adult; D000758:Anesthesia / Q000379:methods; D000818:Animals; D003422:Critical Care; D004353:Drug Evaluation, Preclinical; D006801:Humans; D006979:Hyperthermia, Induced / Q000009:adverse effects / Q000379:methods; D018696:Neuroprotective Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology; D016032:Randomized Controlled Trials as Topic; D020196:Trauma, Nervous System / Q000517:prevention & control*; D014978:Xenon / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology
D018696:Neuroprotective Agents; D014978:Xenon