***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Xenon has repeatedly been demonstrated to have only minimal hemodynamic side effects when compared to other anesthetics . Moreover , in experimental models , xenon was found to be neuroprotective and devoid of developmental neurotoxicity . These properties could render xenon attractive for the anesthesia in neonates and infants with congenital heart disease . However , experience with xenon anesthesia in children is scarce . AIMS We hypothesized that in children undergoing cardiac catheterization , general anesthesia with a combination of sevoflurane with xenon results in superior hemodynamic stability , compared to sevoflurane alone . METHODS In this prospect i ve , r and omized , single-blinded , controlled clinical trial , children with a median age of 12 [ IQR 3 - 36 ] months undergoing diagnostic/interventional cardiac catheterization were r and omized to either general anesthesia with 50 - 65vol% xenon plus sevoflurane or sevoflurane alone . The primary outcome was the incidence of intraprocedural hemodynamic instability , defined as the occurrence of : ( i ) a heart rate change > 20 % from baseline ; or ( ii ) a change in mean arterial blood pressure > 20 % from baseline ; or ( iii ) the requirement of vasopressors , inotropes , chronotropes , or fluid boluses . Secondary endpoints included recovery characteristics , feasibility criteria , and safety ( incidence of emergence agitation and postoperative vomiting . RESULTS After inclusion of 40 children , the trial was stopped as an a priori planned blinded interim analysis revealed that the overall rate of hemodynamic instability did not differ between groups [ 100 % in both the xenon-sevoflurane and the sevoflurane group . However , the adjuvant administration of xenon decreased vasopressor requirements , preserved better cerebral oxygen saturation , and result ed in a faster recovery .  Xenon anesthesia was feasible ( with no differences in the need for rescue anesthetics in both groups ) . CONCLUSION Our observations suggest that combining xenon with sevoflurane in preschool children is safe , feasible , and facilitates hemodynamic management . Larger and adequately powered clinical trials are warranted to investigate the impact of xenon on short- and long-term outcomes in pediatric anesthesia Background : Prognostication in comatose survivors of cardiac arrest is a major clinical challenge . The authors ’ objective was to determine whether an assessment with diffusion tensor imaging , a brain magnetic resonance imaging sequence , increases the accuracy of 1 yr functional outcome prediction in cardiac arrest survivors . Methods : Prospect i ve , observational study in two intensive care units . Fifty-seven comatose survivors of cardiac arrest underwent brain magnetic resonance imaging .  Fractional anisotropy ( FA ) , a diffusion tensor imaging value , was measured in predefined white matter regions , and apparent diffusion coefficient was assessed in predefined grey matter regions . Prediction of unfavorable outcome at 1 yr was compared using four prognostic models : FA global , FA selected , apparent diffusion coefficient , and clinical classifiers . Results : Of the 57 patients included in the study , 49 had an unfavorable outcome at 12 months . Areas under the receiver operating characteristic curve ( 95 % CI ) to predict unfavorable outcome for the FA global , FA selected , clinical , and apparent diffusion coefficient models were 0.92 ( 0.82–0.98 ) , 0.96 ( 0.87–0.99 ) , 0.78 ( 0.65–0.88 ) , and 0.86 ( 0.74–0.94 ) , respectively . The FA selected model had the best overall accuracy for predicting outcome , with a score above 0.44 having 94 % ( 95 % CI , 83–99 % ) sensitivity and 100 % ( 95 % CI , 63–100 % ) specificity for the prediction of unfavorable outcome . Conclusion : Quantitative diffusion tensor imaging indicates that white matter damage is widespread after cardiac arrest . A prognostic model based on FA values in selected white matter tracts seems to predict accurately 1 yr functional outcome . These preliminary results need to be confirmed in a larger population Background : 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 . Methods : This was a phase II , multicentre , r and omized , 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 r and omly 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 ) . Results : 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 . Conclusions : 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 . Clinical trial registration : EudraCT 2009–017153–35 ; Clinical Trials.gov NCT01199276 BACKGROUND Xenon anaesthesia is associated with rapid recovery and may also offer protection against neuronal damage . The aim of this study was to compare xenon with propofol for supplementary general anaesthesia in patients undergoing knee replacement in spinal anaesthesia . METHODS In total , 39 patients aged 60 or over were r and omized to xenon 50 - 70 % or propofol 3 - 5 mg kg(-1 ) h(-1 ) . Vital signs and emergence time were recorded and cognitive function was assessed before operation , at discharge between the third and the fifth day and at 3 months using four neuropsychological tests . RESULTS Propofol supplementation was necessary in six xenon patients ( 29 % ) because of detectable movement of the upper body . Emergence time was significantly shorter with xenon ( 260 s for xenon and 590 s for propofol , P=0.001 ) . There was no significant difference between the groups in blood pressure , heart rate , ventilatory frequency or end-tidal carbon dioxide concentration . No difference could be detected in cognitive function , which may be attributed to insufficient sample -size rather than the absence of a true difference . CONCLUSIONS Xenon was well tolerated for supplementary general anaesthesia in elderly spontaneously breathing patients but supplementation may be necessary . Compared with propofol , emergence was faster with xenon . A larger sample -size is needed if cognitive function is to be addressed Objective : Treatment options to ameliorate brain damage  following cardiopulmonary resuscitation from cardiac arrest are limited . Design : In a porcine model , we evaluated the effects of xenon treatment on neuropathologic and functional outcomes after cardiopulmonary resuscitation . Setting : Prospect i ve , r and omized laboratory animal study . Subjects : Male pigs . Interventions : Following successful resuscitation from 8 mins of cardiac arrest and 5 mins of cardiopulmonary resuscitation , 24 pigs were r and omized to one of three groups receiving either 70 % xenon for 1 or 5 hrs or untreated controls receiving 70 % nitrogen . Measurements and Main Results : Gas exchange , hemodynamics , and lactate and glucose levels were measured at baseline and in the postresuscitation period . On four postoperative days , neurocognitive and overall neurologic deficits were assessed before day 5 , when the brains were harvested for histologic analysis of predefined regions using a semiquantitative score ( 0–10 % = 1 , 10–20 % = 2 , 20–50 % = 3 , 50–80 % = 4 , 80–100 % = 5 ) . No differences in gas exchange , hemodynamics , or lactate and glucose levels were observed among the groups . Animals exposed to 1 and 5 hrs of xenon showed significantly reduced scores for necrotic neurons in the putamen ( 1.25 ± 0.5 and 1.25 ± 0.5 vs. 2.5 ± 1.2 ; p < 0.05 ) , accompanied by significantly lesser scores for perivascular inflammation in putamen ( 0.8 ± 0.5 and 1.1 ± 0.8 vs. 2.1 ± 1.1 ; p < 0.05 ) and cau date nucleus ( 1.0 ± 0.8 and 0.6 ± 0.7 vs. 2.0 ± 1.1 ; p < 0.05 ) . This result ed in improved neurocognitive and neurologic function on day 1 to 3 after cardiopulmonary resuscitation in xenon-treated animals . Conclusions : In this experimental study of cardiac arrest-induced neurologic damage , xenon conferred neurohistopathologic protection , translating in transiently improved functional outcome Facilitation of the coordination of presurgical care is desirable not only from the patients ' perspective , but also for increasing operating room productivity of surgeons and anesthesiologists . Times from each patient 's first referral to a surgeon until surgery will be available on a vast scale from regional health information exchanges . Treatments ( interventions ) can include , for example , case management and use of health system networks with common electronic medical records . We developed a method to compare waiting times between treatment ( intervention ) groups , while stratifying by procedure , despite ( 1 ) highly skewed but non-lognormally distributed data , ( 2 ) highly heterogeneous sample sizes among groups and procedures , and ( 3 ) many combinations of groups and procedures with small sample sizes , result ing in estimated means and variances having substantial uncertainty . Corresponding results obtained by analyzing data from a health system were as follows . ( 1 ) The method uses a r and om-effects model to accommo date procedure heterogeneity and is otherwise distribution free . Log transformation reduced the skewness in waiting time data , making the distribution-free first-order Taylor series approximation analysis of proportional changes between treatments ( interventions ) reasonable . However , when instead of the r and om-effects distribution-free analysis , the assumption was made of lognormal distributions , the estimate of treatment effect was biased . ( 2 ) Repeating the analysis without stratification by procedure also result ed in biased estimates . ( 3 ) There are nearly an unlimited number of different procedures , most rare , so that considering procedure as a r and om effect was appropriate . Over the ranges of estimated parameter values , prior Monte-Carlo simulation studies showed that meta- analysis using the simple method of moments was appropriate . However , because many treatment/procedure combinations have small sample sizes , confidence interval coverage for the treatment effect was too narrow other than when the degrees of freedom were corrected . Nevertheless , the result ing statistical methodology is straightforward to apply because the data needed are just the summary statistics and the method involves just a series of equations to be followed in a stepwise manner ( e.g. , in a spreadsheet program such as Microsoft Office Excel ) Background Performance of patients immediately after anaesthesia is an area of special interest and so a clinical trial was conducted to compare Xenon with Isoflurane anaesthesia . In order to assess the early cognitive recovery the syndrome short test ( SST ) according to Erzigkeit ( Geromed GmbH ) was applied . Methods ASA I and II patients undergoing long and short surgical interventions were r and omised to receive either general anaesthesia with Xenon or Isoflurane .  The primary endpoint was the vali date d SST which covering memory disturbances and attentiveness . The test was used on the day prior to intervention , one and three hours post extubation . The secondary endpoint was the recovery index ( RI ) measured after the end of the inhalation of Xenon or Isoflurane . In addition the Aldrete score was evaluated up to 180 min . On the first post-operative day the patients rated the quality of the anaesthetic using a scoring system from 1 - 6 . Results The demographics of the groups were similar . The sum score of the SST delivered a clear trend one hour post extubation and a statistically significant superiority for Xenon three hours post extubation ( p < 0.01 ) . The RI likewise revealed a statistically significant superiority of Xenon 5 minutes post extubation ( p < 0.01 ) . The Aldrete score was significantly higher for 45 min . The scoring system results were also better after Xen 
    Output:
    
Compared with therapeutic hypothermia alone , xenon and therapeutic hypothermia  reduced cerebral white matter abnormalities after cardiac arrest but had no effect on neurocognitive outcome and mortality .
Xenon had no added value when used to treat neonatal asphyxia .
No differences in biochemical ( S-100β , neuron-specific enolase ) and neuropsychologic ( attentional performance ) outcomes were found with xenon compared with other anesthetic drugs .
Conclusions Despite promising pre- clinical results , the evidence for positive clinical neurologic and cognitive outcomes associated with xenon administration is modest .
Nevertheless , there is some evidence to suggest that xenon may be associated with better neurologic outcomes compared with the st and ard of care therapy in certain specific clinical situations .
Comparativement à l’hypothermie thérapeutique seule , le xénon associé à l’hypothermie thérapeutique a réduit les anomalies de la substance blanche cérébrale après un arrêt cardiaque , mais n’a eu aucun effet sur l’évolution neurocognitive et la mortalité .
Le xénon n’a apporté aucune valeur ajoutée au traitement de l’asphyxie néonatale .
Treize ECR ont comparé les effets neurocognitifs du xénon à ceux d’autres agents anesthésiques chez des patients chirurgicaux .
Aucune différence sur des critères biochimiques ( énolase spécifique des neurones , S-100β ) et neuropsychologiques ( performance de l’attention ) n’a été constatée avec le xénon par rapport aux autres agents anesthésiques .
Enfin , deux études suggèrent qu’une administration brève et intermittente de doses infra-anesthésiques de xénon à des patients en phase aiguë de sevrage de substance peut améliorer l’évolution neurocognitive .
Conclusions Malgré des résultats précliniques prometteurs , les données probantes d’effets cliniques neurologiques et cognitifs positifs associés à l’administration de xénon restent modestes .