High Flow Oxygen Therapy and Acute Ischemic Stroke

Chulalongkorn University

Status: Completed

Conditions: Stroke

Treatments: Device: Low flow oxygen; Device: High flow oxygen

Study type: Interventional

Funder types: Other

Identifiers

NCT03402594

436/59

Details and patient eligibility

About

Hypoxemia is common in acute ischemic stroke and associated with neurological deterioration and mortality. However, the benefit of oxygen therapy is controversial. Severity of stroke may affect the benefit of oxygen supplementation. Abnormal breathing patterns are commonly found among stroke patients and may increase the risk of hypoxemia. High flow nasal cannula (HFNC) has several advantages from controllable fraction of inspired oxygen (FiO2), reduction of nasopharyngeal resistance and positive end expiratory pressure effect. In this study, we aimed to assess the therapeutic effect of HFNC on oxygen desaturation index (ODI) and neurological outcomes in stroke patients with moderate and severe severities, compared with no and low flow oxygen supplementation.

Enrollment: 30 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Age of 18 or more
2. Clinical and radiographic findings including computerized tomography of brain compatible with acute ischemic stroke
3. Presentation within 72 hours after the stroke onset
4. National of Health Stroke Scale (NIHSS) of 5 or more,
5. Limb weakness defined as motor power grade of 4 or less,
6. Able to give informed consent, or the next of kin was willing to give assent

Exclusion criteria

1. Recognized indications for oxygen treatment, such as oxygen saturation on room air of less than 92%, acute left ventricular failure, severe pneumonia, pulmonary emboli, and chronic respiratory failure treated with home oxygen supplementation
2. Recognized contraindications for oxygen treatment including chronic hypercapnia and type II respiratory failure
3. Subjects with previous diagnosis of obstructive sleep apnea (OSA) or highly suspicious of OSA, screened by STOPBANG score of 5 or more

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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30 participants in 3 patient groups

No oxygen

No Intervention group

Description:

No oxygen supplementation given

Low flow oxygen

Active Comparator group

Description:

Oxygen cannula with a flow rate of 2 liter/minute

Treatment:

Device: Low flow oxygen

High flow oxygen

Experimental group

Description:

Heated humidified high flow oxygen cannula (Optiflow; temperature of 34°C and fractional inspired oxygen of 0.24) with a flow rate of 20 liter/minute

Treatment:

Device: High flow oxygen