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Mechanical ventilation in ischemic stroke

Didier Milhaud1, Julius Popp, Eric Thouvenot

  • 1Neurological Intensive Care Unit, Neurology A, Montpellier University Hospital, Montpellier, France. d-milhaud@chu-montpellier.fr

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|October 2, 2007
PubMed
Abstract

Insights

Patients with acute ischemic stroke in the middle cerebral artery territory requiring mechanical ventilation face high mortality. Survival is linked to less extensive stroke involvement and an atherosclerosis cause.

Area of Science:

  • Neurology
  • Critical Care Medicine
  • Vascular Neurology

Background:

  • Acute ischemic stroke (IS) affecting the middle cerebral artery (MCA) can necessitate mechanical ventilation (MV) due to coma or respiratory failure.
  • Previous research on MV in stroke patients utilized heterogeneous inclusion criteria, limiting comparability.

Purpose of the Study:

  • To prospectively evaluate clinical and radiologic features, mortality, and outcome in acute IS patients with MCA involvement requiring MV.
  • To identify prognostic factors for survival in this patient cohort.

Main Methods:

  • Prospective enrollment of 50 patients with acute IS involving the MCA territory who required MV.
  • Intubation indications included Glasgow Coma Scale score <10 or respiratory failure.

Main Results:

  • One-year survival rate was 30%, with 70% mortality.
  • Mortality was not dependent on the specific indication for ventilation.
  • Survivors exhibited incomplete MCA territory involvement and had an atherosclerosis origin for their stroke.

Conclusions:

  • Mechanical ventilation in MCA IS patients is associated with high mortality, irrespective of the intubation reason.
  • Survival outcomes are positively associated with less severe MCA territory involvement and stroke etiology related to atherosclerosis.

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