The hip fracture surgery in elderly patients (HIPELD) study to evaluate xenon anaesthesia for the prevention of postoperative delirium: a multicentre, randomized clinical trial

M. Coburn; R.D. Sanders; M. Maze; M.-L. Nguyên-Pascal; S. Rex; B. Garrigues; J.A. Carbonell; M.L. Garcia-Perez; A. Stevanovic; P. Kienbaum; M. Neukirchen; M.S. Schaefer; B. Borghi; H. van Oven; A. Tognù; L. Al Tmimi; L. Eyrolle; O. Langeron; X. Capdevila; G.M. Arnold; M. Schaller; R. Rossaint; Mark Coburn; Rolf Rossaint; Ana Stevanovic; Christian Stoppe; Astrid Fahlenkamp; Marc Felzen; Mathias Knobe; Robert D. Sanders; Mervyn Maze; My-Liên Nguyên-Pascal; Manuella Schaller; Beatriz Garrigues; José Antonio Carbonell; Marisa Luisa Garcia-Perez; Francisco J. Belda; Marina Soro; C. Ferrando; Irene León; J. Hernadez; Battista Borghi; Hanna van Oven; Andrea Tognù; Aurora Guglielmetti; Barbara Rossi; Greta Fini; Pina Gallerani; Peter Kienbaum; Martin Neukirchen; Maximilian Sebastian Schaefer; Bea Bastin; Dina Kuschka; Thorsten Eisenach; Nina Gaza; Steffen Rex; Layth Al tmimi; Sarah Devroe; Marc Van de Velde; Luc Eyrolle; Patrick Jacquinot; Nadia Rosencher; Olivier Langeron; Sabine Roche; Marie Paries; Xavier Capdevila; Glenn Arnold; Benjamin Graham; Patrick Doyle; P. Albaladejo; Vincent Minville; Fabrice Ferré; Oliver Kunitz; HIPELD Study Investigators

doi:10.1016/j.bja.2017.11.015

$The hip fracture surgery in elderly patients (HIPELD) study to evaluate xenon anaesthesia for the prevention of postoperative delirium: a multicentre, randomized clinical trial$

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The hip fracture surgery in elderly patients (HIPELD) study to evaluate xenon anaesthesia for the prevention of postoperative delirium: a multicentre, randomized clinical trial

M. Coburn, R.D. Sanders, M. Maze, M.-L. Nguyên-Pascal, S. Rex, B. Garrigues, J.A. Carbonell, M.L. Garcia-Perez, A. Stevanovic, P. Kienbaum, …

British journal of anaesthesia : BJA, Vol.120(1), pp.127-137

01/2018

DOI: https://doi.org/10.1016/j.bja.2017.11.015

PMID: 29397119

Résumé

aged

anaesthesia, general

delirium

hip fractures

xenon

Postoperative delirium occurs frequently in elderly hip fracture surgery patients and is associated with poorer overall outcomes. Because xenon anaesthesia has neuroprotective properties, we evaluated its effect on the incidence of delirium and other outcomes after hip fracture surgery. This was a phase II, multicentre, randomized, double-blind, parallel-group, controlled clinical trial conducted in hospitals in six European countries (September 2010 to October 2014). Elderly (≥75yr-old) and mentally functional hip fracture patients were randomly assigned 1:1 to receive either xenon- or sevoflurane-based general anaesthesia during surgery. The primary outcome was postoperative delirium diagnosed through postoperative day 4. Secondary outcomes were delirium diagnosed anytime after surgery, postoperative sequential organ failure assessment (SOFA) scores, and adverse events (AEs). Of 256 enrolled patients, 124 were treated with xenon and 132 with sevoflurane. The incidence of delirium with xenon (9.7% [95% CI: 4.5 -14.9]) or with sevoflurane (13.6% [95% CI: 7.8 -19.5]) were not significantly different (P=0.33). Overall SOFA scores were significantly lower with xenon (least-squares mean difference: −0.33 [95% CI: −0.60 to −0.06]; P=0.017). For xenon and sevoflurane, the incidence of serious AEs and fatal AEs was 8.0% vs 15.9% (P=0.05) and 0% vs 3.8% (P=0.06), respectively. Xenon anaesthesia did not significantly reduce the incidence of postoperative delirium after hip fracture surgery. Nevertheless, exploratory observations concerning postoperative SOFA-scores, serious AEs, and deaths warrant further study of the potential benefits of xenon anaesthesia in elderly hip fracture surgery patients. EudraCT 2009-017153-35; ClinicalTrials.gov NCT01199276.

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Titre: The hip fracture surgery in elderly patients (HIPELD) study to evaluate xenon anaesthesia for the prevention of postoperative delirium: a multicentre, randomized clinical trial
Créateurs - sans rôle: M. Coburn - Department of Anaesthesiology, University Hospital RWTH Aachen, Pauwelsstraße 30, D-52074 Aachen, Germany
R.D. Sanders - Department of Anesthesiology, Anesthesiology & Critical Care Trials & Interdisciplinary Outcome Network (ACTION), University of Wisconsin, Madison, WI, USA
M. Maze - Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, CA, USA
M.-L. Nguyên-Pascal - Air Liquide Santé International, Medical Research & Development, Jouy-en-Josas, France
S. Rex - Department of Anaesthesiology, University Hospitals Leuven, Leuven, Belgium
B. Garrigues - Department of Anaesthesia and Surgical Intensive Care, Hospital Clínico, Universitario de Valencia, Valencia, Spain
J.A. Carbonell - Department of Anaesthesia and Surgical Intensive Care, Hospital Clínico, Universitario de Valencia, Valencia, Spain
M.L. Garcia-Perez - Department of Anaesthesia and Surgical Intensive Care, Hospital Clínico, Universitario de Valencia, Valencia, Spain
A. Stevanovic - Department of Anaesthesiology, University Hospital RWTH Aachen, Pauwelsstraße 30, D-52074 Aachen, Germany
P. Kienbaum - Department of Anaesthesia, University Hospital Düsseldorf, Düsseldorf, Germany
M. Neukirchen - Department of Anaesthesia, University Hospital Düsseldorf, Düsseldorf, Germany
M.S. Schaefer - Department of Anaesthesia, University Hospital Düsseldorf, Düsseldorf, Germany
B. Borghi - Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
H. van Oven - Anesthesia and Postoperative Intensive Care, Rizzoli Orthopedic Institute, Bologna, Italy
A. Tognù - Anesthesia and Postoperative Intensive Care, Rizzoli Orthopedic Institute, Bologna, Italy
L. Al Tmimi - Department of Anaesthesiology, University Hospitals Leuven, Leuven, Belgium
L. Eyrolle - Department of Anaesthesia and Surgical Intensive Care, Groupe Hospitalier Cochin–Saint Vincent de Paul, Paris, France
O. Langeron - Department of Anaesthesia and Intensive Care, Hôpital Universitaire Pitié-Salpêtrière APHP, Paris, France
X. Capdevila - Department of Anaesthesia, Centre Hospitalier Régional Universitaire de Montpellier, Hôpital Lapeyronie, Montpellier, France
G.M. Arnold - Department of Anaesthesia, Imperial College NHS Trust, London, UK
M. Schaller - Air Liquide Santé International, Medical Research & Development, Jouy-en-Josas, France
R. Rossaint - Department of Anaesthesiology, University Hospital RWTH Aachen, Pauwelsstraße 30, D-52074 Aachen, Germany
Mark Coburn - Department of Anaesthesiology, University Hospital RWTH Aachen, Aachen, Germany
Rolf Rossaint - Department of Anaesthesiology, University Hospital RWTH Aachen, Aachen, Germany
Ana Stevanovic - Department of Anaesthesiology, University Hospital RWTH Aachen, Aachen, Germany
Christian Stoppe - Department of Anaesthesiology, University Hospital RWTH Aachen, Aachen, Germany
Astrid Fahlenkamp - Department of Anaesthesiology, University Hospital RWTH Aachen, Aachen, Germany
Marc Felzen - Department of Anaesthesiology, University Hospital RWTH Aachen, Aachen, Germany
Mathias Knobe - Department of Orthopaedic Trauma Surgery, University Hospital RWTH Aachen, Aachen, Germany
Robert D. Sanders - Anesthesiology & Critical Care Trials & Interdisciplinary Outcome Network (ACTION), Department of Anesthesiology, University of Wisconsin, Madison, WI, USA
Mervyn Maze - Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, CA, USA
My-Liên Nguyên-Pascal - Air Liquide Santé International, Medical Research & Development, Jouy-en-Josas, France
Manuella Schaller - Air Liquide Santé International, Medical Research & Development, Jouy-en-Josas, France
Beatriz Garrigues - Department of Anaesthesia and Surgical Critical Care, Hospital Clínico Universitario deValencia, Valencia, Spain
José Antonio Carbonell - Department of Anaesthesia and Surgical Critical Care, Hospital Clínico Universitario deValencia, Valencia, Spain
Marisa Luisa Garcia-Perez - Department of Anaesthesia and Surgical Critical Care, Hospital Clínico Universitario deValencia, Valencia, Spain
Francisco J. Belda - Department of Anaesthesia and Surgical Critical Care, Hospital Clínico Universitario deValencia, Valencia, Spain
Marina Soro - Department of Anaesthesia and Surgical Critical Care, Hospital Clínico Universitario deValencia, Valencia, Spain
C. Ferrando - Department of Anaesthesia and Surgical Critical Care, Hospital Clínico Universitario deValencia, Valencia, Spain
Irene León - Department of Anaesthesia and Surgical Critical Care, Hospital Clínico Universitario deValencia, Valencia, Spain
J. Hernadez - Department of Anaesthesia and Surgical Critical Care, Hospital Clínico Universitario deValencia, Valencia, Spain
Battista Borghi - Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
Hanna van Oven - Anaesthesia and Postoperative Intensive Care, Rizzoli Orthopaedic Institute, Bologna, Italy
Andrea Tognù - Anaesthesia and Postoperative Intensive Care, Rizzoli Orthopaedic Institute, Bologna, Italy
Aurora Guglielmetti - Anaesthesia and Postoperative Intensive Care, Rizzoli Orthopaedic Institute, Bologna, Italy
Barbara Rossi - Research Unit of Anaesthesia and Pain Therapy, Rizzoli Orthopaedic Institute, Bologna, Italy
Greta Fini - Research Unit of Anaesthesia and Pain Therapy, Rizzoli Orthopaedic Institute, Bologna, Italy
Pina Gallerani - Research Unit of Anaesthesia and Pain Therapy, Rizzoli Orthopaedic Institute, Bologna, Italy
Peter Kienbaum - Department of Anaesthesia, University Hospital Düsseldorf, Düsseldorf, Germany
Martin Neukirchen - Department of Anaesthesia, University Hospital Düsseldorf, Düsseldorf, Germany
Maximilian Sebastian Schaefer - Department of Anaesthesia, University Hospital Düsseldorf, Düsseldorf, Germany
Bea Bastin - Department of Anaesthesia, University Hospital Düsseldorf, Düsseldorf, Germany
Dina Kuschka - Department of Anaesthesia, University Hospital Düsseldorf, Düsseldorf, Germany
Thorsten Eisenach - Department of Anaesthesia, University Hospital Düsseldorf, Düsseldorf, Germany
Nina Gaza - Department of Anaesthesia, University Hospital Düsseldorf, Düsseldorf, Germany
Steffen Rex - Department of Anaesthesiology, University Hospitals Leuven, Leuven, Belgium
Layth Al tmimi - Department of Anaesthesiology, University Hospitals Leuven, Leuven, Belgium
Sarah Devroe - Department of Anaesthesiology, University Hospitals Leuven, Leuven, Belgium
Marc Van de Velde - Department of Anaesthesiology, University Hospitals Leuven, Leuven, Belgium
Luc Eyrolle - Department of Anaesthesia and Surgical Intensive Care, Groupe Hospitalier Cochin – Saint Vincent de Paul, Paris, France
Patrick Jacquinot - Department of Anaesthesia and Surgical Intensive Care, Groupe Hospitalier Cochin – Saint Vincent de Paul, Paris, France
Nadia Rosencher - Department of Anaesthesia and Surgical Intensive Care, Groupe Hospitalier Cochin – Saint Vincent de Paul, Paris, France
Olivier Langeron - Department of Anaesthesia and Intensive Care, Groupe Hospitalier Pitié-Salpetrieìre, Université Pierre et Marie Curie, Paris VI, France
Sabine Roche - Department of Anaesthesia and Intensive Care, Groupe Hospitalier Pitié-Salpetrieìre, Université Pierre et Marie Curie, Paris VI, France
Marie Paries - Department of Anaesthesia and Intensive Care, Groupe Hospitalier Pitié-Salpetrieìre, Université Pierre et Marie Curie, Paris VI, France
Xavier Capdevila - Department of Anaesthesia, Centre Hospitalier Régional Universitaire de Montpellier, Hôpital Lapeyronie, Montpellier, France
Glenn Arnold - Department of Anaesthesia, Imperial College NHS Trust, London, UK
Benjamin Graham - Department of Anaesthesia, Imperial College NHS Trust, London, UK
Patrick Doyle - Department of Anaesthesia, Imperial College NHS Trust, London, UK
P. Albaladejo - Department of Anaesthesia, Centre Hospitalier et Universitaire de Grenoble, Hôpital Michallon, La Tronche, France
Vincent Minville - Department of Anaesthesia and Intensive Care Medicine, Centre Hospitalier et Universitaire de Toulouse, Hôpital Rangueil, Toulouse, France
Fabrice Ferré - Department of Anaesthesia and Intensive Care Medicine, Centre Hospitalier et Universitaire de Toulouse, Hôpital Rangueil, Toulouse, France
Oliver Kunitz - Department of Anaesthesia, Emergency and Intensive Care Medicine, Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier, Germany
HIPELD Study Investigators
Détails de publication: British journal of anaesthesia : BJA, Vol.120(1), pp.127-137
Éditeur: Elsevier Ltd
Nombre de pages: 11
Identifiants: 99139840509311
Unité académique: Institut des Neurosciences de Montpellier - INM
Langue: English
Type de ressource: Journal article