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Elective intubation for neurologic deterioration after stroke
J Grotta1, W Pasteur, G Khwaja
1Department of Neurology, University of Texas Medical School, Houston, USA.
Neurology
|April 1, 1995
Summary
Elective intubation for ischemic stroke is rare (8%) but can lead to satisfactory outcomes. Predictors of good prognosis include higher consciousness levels and early extubation.
Area of Science:
- Neurology
- Critical Care Medicine
- Stroke Management
Background:
- Elective intubation is a critical decision for ischemic stroke patients experiencing neurologic deterioration.
- Understanding outcomes and predictors is essential for guiding clinical practice.
Purpose of the Study:
- To provide data to aid physicians and families in the decision-making process for elective intubation after ischemic stroke.
- To evaluate the clinical course, neurologic outcomes, and psychosocial impact of intubation in this patient group.
Main Methods:
- Retrospective chart review and patient interviews.
- Analysis of 20 patients (8% of 250 cases) electively intubated for neurologic deterioration after acute carotid territory ischemic stroke.
- Assessment of clinical course, neurologic outcome, financial, and psychosocial effects.
Main Results:
- Six of 20 patients survived to discharge, with varying degrees of independence.
- Good outcomes were associated with higher Glasgow Coma Scale scores and extubation within 72 hours.
- Caregivers reported moderate stress but would generally repeat the decision to intubate.
Conclusions:
- Elective intubation can yield satisfactory outcomes in a subset of ischemic stroke patients.
- Predictors of good outcomes include less severe consciousness depression, early extubation, and hemicraniectomy.
- Further research on the cost-benefit of cerebral resuscitation post-stroke is warranted.