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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
PubMed
Summary
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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.

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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.