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The feasibility of using a portable xenon delivery device to permit earlier xenon ventilation with therapeutic cooling of neonates during ambulance retrieval.

AbstractBACKGROUND:
Therapeutic hypothermia is the standard of care after perinatal asphyxia. Preclinical studies show 50% xenon improves outcome, if started early.
METHODS:
During a 32-patient study randomized between hypothermia only and hypothermia with xenon, 5 neonates were given xenon during retrieval using a closed-circuit incubator-mounted system.
RESULTS:
Without xenon availability during retrieval, 50% of eligible infants exceeded the 5-hour treatment window. With the transportable system, 100% were recruited. Xenon delivery lasted 55 to 120 minutes, using 174 mL/h (117.5-193.2) (median [interquartile range]), after circuit priming (1300 mL).
CONCLUSIONS:
Xenon delivery during ambulance retrieval was feasible, reduced starting delays, and used very little gas.
AuthorsJohn Dingley, Xun Liu, Hannah Gill, Elisa Smit, Hemmen Sabir, James Tooley, Ela Chakkarapani, David Windsor, Marianne Thoresen
JournalAnesthesia and analgesia (Anesth Analg) Vol. 120 Issue 6 Pg. 1331-6 (Jun 2015) ISSN: 1526-7598 [Electronic] United States
PMID25794112 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Xenon
Topics
  • Administration, Inhalation
  • Ambulances
  • Anesthesia, Closed-Circuit (instrumentation)
  • Asphyxia Neonatorum (therapy)
  • Emergency Medical Services
  • England
  • Equipment Design
  • Feasibility Studies
  • Humans
  • Hypothermia, Induced
  • Infant, Newborn
  • Point-of-Care Systems
  • Prospective Studies
  • Respiration, Artificial (instrumentation)
  • Time Factors
  • Treatment Outcome
  • Ventilators, Mechanical
  • Xenon (administration & dosage)

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