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Venturi Mask Adjuvant Oxygen Therapy in Severe Acute Ischemic Stroke
Elley H. H. Chiu, MD;
Chin-San Liu, MD, PhD;
Teng-Yeow Tan, MD;
Ku-Chou Chang, MD
Arch Neurol. 2006;63:741-744.
Background The effect of oxygen therapy in acute ischemic stroke remains undetermined.
Objective To investigate the feasibility of eubaric hyperoxia therapy by Venturi mask (VM) in a group of patients who experienced a severe acute ischemic stroke.
Design Patients experiencing a first-ever large middle cerebral artery infarction were recruited within 48 hours after stroke. Patients were subdivided to undergo therapy with a VM with a fraction of inspired oxygen of 40% or with a nasal cannula. A large middle cerebral artery infarction was defined as a large low-attenuation area of more than one third of the middle cerebral artery territory on brain images. Stroke severity was evaluated by the National Institutes of Health Stroke Scale.
Results Seventeen patients were enrolled in the VM group and 29 in the nasal cannula group. All the demographic and clinical characteristics were equally distributed initially. The mean initial National Institutes of Health Stroke Scale score was 20.5 and 18.9 in the VM and nasal cannula groups, respectively. Atrial fibrillation was found in 11 (65%) patients in the VM and 17 (59%) patients in the nasal cannula groups. The VM therapy was initiated within 13.7 (range, 3.0-41.5) hours after stroke and the duration was 132.9 (range, 48.0-168.5) hours. In-hospital mortality was 1 (6%) in the VM group and 7 (24%) in the nasal cannula group (P=.12). In the VM group, there were fewer incidences of fever (4 [24%] vs 15 [52%]; P=.06), pneumonia (1 [6%] vs 6 [21%]; P=.18), and respiratory failure (3 [18%] vs 8 [28%]; P=.45), but a higher incidence of bedsores (3 [18%] vs 2 [7%]; P=.29).
Conclusions By using VM therapy with a fraction of inspired oxygen of 40%, there might be less mortality and comorbidities in treated patients who experienced a severe acute ischemic stroke. Further randomized confirmatory studies should explore the decreased mortality in patients who experience a severe acute ischemic stroke, especially in those with a large middle cerebral artery infarction who undergo VM therapy with a fraction of inspired oxygen of 40%.
Author Affiliations: Division of Acupuncture (Dr Chiu), Departments of Traditional Chinese Medicine (Dr Chiu) and Neurology (Drs Chiu, Tan, and Chang), Chang Gung Memorial Hospital, Kaohsiung; College of Medicine, Chang Gung University, Taoyuan (Drs Tan and Chang); Department of Neurology and Vascular and Genomic Research Center, Changhua Christian Hospital, Changhua (Dr Liu); and Department of Neurology, Chung Shan Medical University and Chung Shan Medical University Hospital, Taichung (Dr Liu), Taiwan.
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