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Ventilation Time and Prognosis After Stroke Thrombectomy: The Shorter, the Better!

By Currents Editor posted 03-02-2020 10:18

  

European Journal of Neurology (02/17/20) doi: 10.1111/ene.14178

Fandler‐Höfler, Simon; Heschl, Stefan; Kneihsl, Markus; et al.

For stroke patients receiving mechanical thrombectomy (MT), extubation should occur as early as safely possible, Austrian researchers report, citing as association between prolonged ventilation and unfavorable outcome at 3 months and increased rates of pneumonia. Their study involved 447 consecutive ischemic stroke patients who had been treated at their facility with MT for anterior circulation large vessel occlusion under general anesthesia over an 8-year period. The median ventilation time was three hours, and 42.6% (188) patients had a favorable 3-month outcome, which was associated with a shorter time on ventilation. Multivariable analysis confirmed that for individuals extubated within 24 hours, early extubation (within 6 hours) was linked to greater outcomes, compared with delayed extubation (between 6-24 hours). Additionally, there was an association between longer ventilation time and an increased rate of pneumonia during neurointensive care unit/stroke unit state, ranging from 9.6% for those with early extubation to 27.7% for those who received late extubation (more than 24 hours). The most frequent reason for late extubation was stroke-related complications, while delayed extubation was tied to admission outside of general business hours.

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FURTHER READING
Yang P, Zhang Y, Zhang L, et al. Endovascular Thrombectomy with or without Intravenous Alteplase in Acute Stroke. N Engl J Med . 2020 May 21;382(21):1981-93. Reviewed by Wazim Mohamed, MD Read the article .*   *You will need to log in to US National Library of Medicine National Institutes ...
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