Protection of xenon against postoperative oxygen impairment in adults undergoing Stanford Type-A acute aortic dissection surgery: Study protocol for a prospective, randomized controlled clinical trial

Medicine (Baltimore). 2017 Aug;96(34):e7857. doi: 10.1097/MD.0000000000007857.

Abstract

Objectives: The available evidence shows that hypoxemia after Stanford Type-A acute aortic dissection (AAD) surgery is a frequent cause of several adverse consequences. The pathogenesis of postoperative hypoxemia after AAD surgery is complex, and ischemia/reperfusion and inflammation are likely to be underlying risk factors. Xenon, recognized as an ideal anesthetic and anti-inflammatory treatment, might be a possible treatment for these adverse effects.

Methods/design: The trial is a prospective, double-blind, 4-group, parallel, randomized controlled, a signal-center clinical trial. We will recruit 160 adult patients undergoing Stanford type-A AAD surgery. Patients will be allocated a study number and will be randomized on a 1:1:1:1 basis to receive 1 of the 3 treatment options (pulmonary inflated with 50% xenon, 75% xenon, or 100% xenon) or no treatment (control group, pulmonary inflated with 50% nitrogen). The aims of this study are to clarify the lung protection capability of xenon and its possible mechanisms in patients undergoing the Stanford type-A AAD surgery.

Discussion: This trial uses an innovative design to account for the xenon effects of postoperative oxygen impairment, and it also delineates the mechanism for any benefit from xenon. The investigational xenon group is considered a treatment intervention, as it includes 3 groups of pulmonary static inflation with 50%, 75%, and 100% xenon. It is suggested that future trials might define an appropriate concentration of xenon for the best practice intervention.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Anesthetics, Inhalation / administration & dosage*
  • Aortic Aneurysm, Thoracic / surgery*
  • Aortic Dissection / surgery*
  • Cytokines / metabolism
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Humans
  • Hypoxia / prevention & control
  • Inflammation Mediators / metabolism
  • Postoperative Complications / prevention & control*
  • Prospective Studies
  • Reactive Oxygen Species / metabolism
  • Reperfusion Injury / prevention & control
  • Research Design
  • Risk Factors
  • Xenon / administration & dosage*

Substances

  • Anesthetics, Inhalation
  • Cytokines
  • Inflammation Mediators
  • Reactive Oxygen Species
  • Xenon