Mona N Bahouth1,2, R F Gottesman3, S L Szanton4,5. 1. Department of Neurology, Johns Hopkins School of Medicine, 600 N. Wolfe St, Phipps 486, Baltimore, MD, 21287, USA. mbahout1@jhmi.edu. 2. Johns Hopkins School of Nursing, Baltimore, MD, USA. mbahout1@jhmi.edu. 3. Department of Neurology, Johns Hopkins School of Medicine, 600 N. Wolfe St, Phipps 486, Baltimore, MD, 21287, USA. 4. Johns Hopkins School of Nursing, Baltimore, MD, USA. 5. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Abstract
BACKGROUND AND PURPOSE: Hydration status at the time of stroke has been acknowledged as an important determinant in early stroke recovery. However, the diagnosis of dehydration, or more accurately, a volume-contracted state, at the time of stroke is challenging since there are currently no consensus diagnostic criteria. In this systematic review, we gather the available evidence about diagnosis and treatment of dehydration after stroke. METHODS: Studies of hospitalized ischemic stroke patients that reported rates of dehydration from January 1997 to March 2017 were screened for inclusion via a systematic search of PubMed, CINAHL, Cochrane, and Scopus using keywords hydration, dehydration, hemodilution, viscosity, volume status, and thirst. RESULTS: Twenty-five studies of 8699 acute stroke patients were included. Nineteen studies reported on the diagnostic approach to dehydration. Findings are synthesized into four main categories of available research including studies that specify: (1) biological mechanisms using animal models to investigate the relationship between dehydration and stroke; (2) measures of dehydration in the acute human stroke population; (3) rehydration therapies after stroke; and (4) outcomes after stroke in dehydrated patients. CONCLUSIONS: We found considerable variation in terminology specific to hydration status, diagnostic approach to dehydration, and few prospective studies of treatment strategies with varying results. This review supports the need for consensus development of operational diagnostic criteria, standardization of language, and the opportunity for prospective study of rehydration strategies to impact outcome after stroke.
BACKGROUND AND PURPOSE: Hydration status at the time of stroke has been acknowledged as an important determinant in early stroke recovery. However, the diagnosis of dehydration, or more accurately, a volume-contracted state, at the time of stroke is challenging since there are currently no consensus diagnostic criteria. In this systematic review, we gather the available evidence about diagnosis and treatment of dehydration after stroke. METHODS: Studies of hospitalized ischemic strokepatients that reported rates of dehydration from January 1997 to March 2017 were screened for inclusion via a systematic search of PubMed, CINAHL, Cochrane, and Scopus using keywords hydration, dehydration, hemodilution, viscosity, volume status, and thirst. RESULTS: Twenty-five studies of 8699 acute strokepatients were included. Nineteen studies reported on the diagnostic approach to dehydration. Findings are synthesized into four main categories of available research including studies that specify: (1) biological mechanisms using animal models to investigate the relationship between dehydration and stroke; (2) measures of dehydration in the acute humanstroke population; (3) rehydration therapies after stroke; and (4) outcomes after stroke in dehydrated patients. CONCLUSIONS: We found considerable variation in terminology specific to hydration status, diagnostic approach to dehydration, and few prospective studies of treatment strategies with varying results. This review supports the need for consensus development of operational diagnostic criteria, standardization of language, and the opportunity for prospective study of rehydration strategies to impact outcome after stroke.
Entities:
Keywords:
Acute stroke; Dehydration; Early recovery; Rehydration
Authors: Shrikant D Pande; Debajyoti Roy; Aye Aye Khine; May M Win; Lorecar Lolong; Ni Thu Shan; Pei Ting Tan; Tian Ming Tu Journal: BMJ Open Date: 2022-05-25 Impact factor: 3.006