Neuroprotective Effects of Xenon Treatment in Patients With Cerebral Infarction
Status:
Not yet recruiting
Trial end date:
2024-05-29
Target enrollment:
Participant gender:
Summary
In the Russian Federation, ischemic cerebral infarction is recorded annually in more than
450,000 people. It is the second most common cause of death after coronary heart disease.
The 30-day mortality rate after an ischemic cerebral infarction is more than 25%, and during
the following year about half of the patients die. To date, all candidate neuroprotective
drugs tested in various clinical trials have demonstrated insufficient efficacy . Therefore,
the development of new approaches to the treatment of severe brain injuries of various
etiologies is one of the most important tasks of critical condition medicine.
Brain damage due to stroke triggers a number of pathophysiological reactions, which are based
on the accumulation of glutamate with the development of excitotoxicity. The effect of
glutamate on NMDA receptors is one of the main factors of neurodegenerative disorders.
Xenon is an anesthetic whose neuroprotective properties have been shown in many experimental
studies. Хenon inhalation after ischemia and reperfusion suppresses ischemic brain damage and
tPA-induced cerebral hemorrhages, and damage to the blood-brain barrier.
The most interesting is a randomized controlled trial performed by R. Laitio et al. (2016),
in which the use of xenon in combination with hypothermia in clinical practice was studied
for the first time. In patients who have undergone community-acquired cardiac arrest, xenon
inhalation at a concentration of 40 vol.% within 24 hours in combination with hypothermia,
led to less damage to the white matter of the brain than with patients using hypothermia
alone. The 6-month mortality rate was 27% in the xenon and hypothermia group and 35% in the
hypothermia group.
It is important to note that today, despite a large pool of convincing preclinical studies
proving the neuroprotective properties of xenon, there is not a single clinical study of its
use in ischemic stroke.
Therefore, the research objectives is to determine whether the strategy of using xenon-oxygen
mixture inhalation is better than oxygen-air mixture inhalation with respect to the change in
scores on the NIHSS, Rankin and Glasgow coma scales on day 7, the duration of stay in the ICU
and the frequency of nosocomial pneumonia.