Neuroprotective Effects of Inhaled Xenon Gas on Brain Structural Gray Matter Changes After Out-of-Hospital Cardiac Arrest Evaluated by Morphometric Analysis: A Substudy of the Randomized Xe-Hypotheca Trial.

Autor: Hollmén C; Department of Radiology, Turku University Hospital, University of Turku, Turku, Finland., Parkkola R; Department of Radiology, Turku University Hospital, University of Turku, Turku, Finland., Vorobyev V; Department of Radiology, Turku University Hospital, University of Turku, Turku, Finland., Saunavaara J; Department of Medical Physics, Turku University Hospital, University of Turku, Turku, Finland., Laitio R; Division of Perioperative Services, Intensive Care Medicine and Pain Management, Turku University Hospital, University of Turku, POB 52, 20521, Turku, Finland., Arola O; Division of Perioperative Services, Intensive Care Medicine and Pain Management, Turku University Hospital, University of Turku, POB 52, 20521, Turku, Finland., Hynninen M; Division of Intensive Care Medicine, Department of Anesthesiology, Intensive Care and Pain Medicine, Helsinki University Hospital, University of Helsinki, Helsinki, Finland., Bäcklund M; Division of Intensive Care Medicine, Department of Anesthesiology, Intensive Care and Pain Medicine, Helsinki University Hospital, University of Helsinki, Helsinki, Finland., Martola J; Department of Radiology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland., Ylikoski E; Division of Intensive Care Medicine, Department of Anesthesiology, Intensive Care and Pain Medicine, Helsinki University Hospital, University of Helsinki, Helsinki, Finland., Roine RO; Division of Clinical Neurosciences, Turku University Hospital, University of Turku, Turku, Finland., Tiainen M; Department of Neurology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland., Scheinin H; Division of Perioperative Services, Intensive Care Medicine and Pain Management, Turku University Hospital, University of Turku, POB 52, 20521, Turku, Finland., Maze M; Center for Cerebrovascular Research, Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, CA, USA., Vahlberg T; Department of Biostatistics, University of Turku and Turku University Hospital, Turku, Finland., Laitio TT; Division of Perioperative Services, Intensive Care Medicine and Pain Management, Turku University Hospital, University of Turku, POB 52, 20521, Turku, Finland. timo.laitio@varha.fi.
Jazyk: angličtina
Zdroj: Neurocritical care [Neurocrit Care] 2024 Jul 09. Date of Electronic Publication: 2024 Jul 09.
DOI: 10.1007/s12028-024-02053-8
Abstrakt: Background: We have earlier reported that inhaled xenon combined with hypothermia attenuates brain white matter injury in comatose survivors of out-of-hospital cardiac arrest (OHCA). A predefined secondary objective was to assess the effect of inhaled xenon on the structural changes in gray matter in comatose survivors after OHCA.
Methods: Patients were randomly assigned to receive either inhaled xenon combined with target temperature management (33 °C) for 24 h (n = 55, xenon group) or target temperature management alone (n = 55, control group). A change of brain gray matter volume was assessed with a voxel-based morphometry evaluation of high-resolution structural brain magnetic resonance imaging (MRI) data with Statistical Parametric Mapping. Patients were scheduled to undergo the first MRI between 36 and 52 h and a second MRI 10 days after OHCA.
Results: Of the 110 randomly assigned patients in the Xe-Hypotheca trial, 66 patients completed both MRI scans. After all imaging-based exclusions, 21 patients in the control group and 24 patients in the xenon group had both scan 1 and scan 2 available for analyses with scans that fulfilled the quality criteria. Compared with the xenon group, the control group had a significant decrease in brain gray matter volume in several clusters in the second scan compared with the first. In a between-group analysis, significant reductions were found in the right amygdala/entorhinal cortex (p = 0.025), left amygdala (p = 0.043), left middle temporal gyrus (p = 0.042), left inferior temporal gyrus (p = 0.008), left parahippocampal gyrus (p = 0.042), left temporal pole (p = 0.042), and left cerebellar cortex (p = 0.005). In the remaining gray matter areas, there were no significant changes between the groups.
Conclusions: In comatose survivors of OHCA, inhaled xenon combined with targeted temperature management preserved gray matter better than hypothermia alone.
Clinical Trial Registration: ClinicalTrials.gov: NCT00879892.
(© 2024. Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society.)
Databáze: MEDLINE
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