R R Leker1, T Ben-Hur. 1. Department of Neurology, Hebrew University Hadassah Medical School and Hadassah Medical Center, Ein Kerem, P.O. Box 12000, 91120, Jerusalem, Israel. leker@cc.huji.ac.il
Abstract
OBJECTIVES: To evaluate the reasons for implementing artificial ventilation (AV) in patients with acute ischemic stroke (AIS), determine their outcome and characterize prognostic variables in these patients. METHODS: Consecutive patients presenting with AIS were evaluated. All patients who received AV were treated in a neurological semi-intensive care setting. RESULTS: Of the 173 patients included in the study, 27 (16%) needed AV, 16 (9%) received AV and five of these patients (31%) survived. The mean NIH stroke scale score prior to AV was 14.5+/-5.6 (vs. 9.1+/-6.2 in non-intubated patients, P=0.001). Six patients were ventilated because of neurological deterioration. Most of these patients had large hemispheric infarctions with evident herniation and midline shift on CT scans. The only one who survived the acute hospitalization did not recover and died within 3 months. In the other 10 patients, AV was instituted during cardiopulmonary decompensation (CPD). These patients generally fared better; four of them survived and were discharged after a lengthier hospital stay when compared to non-intubated patients. Variables associated with survival among intubated patients were a lower neurological disability score on admission and on day 7 after the stroke, and intubation during CPD. CONCLUSIONS: Implementing AV in semi-intensive care settings does not seem to improve survival in AIS patients with neurological deterioration. Stroke patients who need AV during CPD and those that have less severe neurological deficits may have better chances for survival.
OBJECTIVES: To evaluate the reasons for implementing artificial ventilation (AV) in patients with acute ischemic stroke (AIS), determine their outcome and characterize prognostic variables in these patients. METHODS: Consecutive patients presenting with AIS were evaluated. All patients who received AV were treated in a neurological semi-intensive care setting. RESULTS: Of the 173 patients included in the study, 27 (16%) needed AV, 16 (9%) received AV and five of these patients (31%) survived. The mean NIH stroke scale score prior to AV was 14.5+/-5.6 (vs. 9.1+/-6.2 in non-intubated patients, P=0.001). Six patients were ventilated because of neurological deterioration. Most of these patients had large hemispheric infarctions with evident herniation and midline shift on CT scans. The only one who survived the acute hospitalization did not recover and died within 3 months. In the other 10 patients, AV was instituted during cardiopulmonary decompensation (CPD). These patients generally fared better; four of them survived and were discharged after a lengthier hospital stay when compared to non-intubated patients. Variables associated with survival among intubated patients were a lower neurological disability score on admission and on day 7 after the stroke, and intubation during CPD. CONCLUSIONS: Implementing AV in semi-intensive care settings does not seem to improve survival in AIS patients with neurological deterioration. Strokepatients who need AV during CPD and those that have less severe neurological deficits may have better chances for survival.
Authors: Eva Schielke; Markus A Busch; Thomas Hildenhagen; Martin Holtkamp; Ingeborg Küchler; Lutz Harms; Florian Masuhr Journal: J Neurol Date: 2005-03-07 Impact factor: 4.849
Authors: R Sonneville; M Mazighi; D Bresson; I Crassard; S Crozier; E de Montmollin; V Degos; F Faugeras; E Gayat; L Josse; C Lamy; E Magalhaes; A Maldjian; S Ruckly; J Servan; P Vassel; B Vigué; J-F Timsit; F Woimant Journal: Neurocrit Care Date: 2020-04 Impact factor: 3.210