A randomized controlled study of intravenous fluid in acute ischemic stroke

Suwanwela, Nijasri C.; Chutinet, Aurauma; Mayotarn, Seangduan; Thanapiyachaikul, Ratchayut; Chaisinanunkul, Napasri; Asawavichienjinda, Thanin; Muengtaweepongsa, Sombat; Nilanont, Yongchai; Samajarn, Jitlada; Watcharasaksilp, Kanokwan; Tiamkao, Somsak; Vongvasinkul, Pakkawan; Charnwut, Supparat; Saver, Jeffrey L.

doi:10.1016/j.clineuro.2017.08.012

Cited by 6 publications

(4 citation statements)

References 17 publications

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“…This finding extended previously reported work that summarized the high prevalence of dehydration among stroke patients ( 2 , 3 ), the significant impact of dehydration on early neurological deterioration and performance on disability scales ( 4 , 6 – 8 ), by adding a physiological basis and imaging evidence. It also supports recent evidence indicating that hydration therapy should be a central feature of acute stroke management ( 1 , 10 , 16 ).…”

Section: Discussionsupporting

confidence: 87%

“…Recent studies have demonstrated that dehydration is common among stroke subjects ( 2 , 3 ), and hydration status is associated with stroke-in-evolution ( 4 , 5 ), discharge outcome and admission costs in acute ischemic stroke ( 6 – 8 ). The reasons for these observations are based on the concept that dehydration status may lead to cerebral hypoperfusion and decreased collateral blood flow, which may exacerbate the ischemic brain injury ( 6 , 9 , 10 ). In an animal study, Paczynski et al reported that both extremes of hydration and dehydration spectrum would lead to more severe brain edema and midline brain structure shifting ( 11 ).…”

Section: Introductionmentioning

confidence: 99%

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Effects of Dehydration on Brain Perfusion and Infarct Core After Acute Middle Cerebral Artery Occlusion in Rats: Evidence From High-Field Magnetic Resonance Imaging

et al. 2018

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Background: Dehydration is common among ischemic stroke patients and is associated with early neurological deterioration and poor outcome. This study aimed to test the hypothesis that dehydration status is associated with decreased cerebral perfusion and aggravation of ischemic brain injury.Methods: Diffusion-weighted imaging and arterial spin labeling perfusion MR imaging were performed on rats with middle cerebral artery occlusion (MCAO) by using a 9.4T MR imaging scanner to measure the volume of infarction and relative cerebral blood flow (rCBF) after infarction. Twenty-five rats were assigned to either a dehydration group or normal hydration group, and dehydration status was achieved by water deprivation for 48 h prior to MCAO.Results: The volume of the infarction was significantly larger for the dehydration group at the 4th h after MCAO (p = 0.040). The progression in the infarct volume between the 1st and 4th h was also larger in the dehydration group (p = 0.021). The average rCBF values of the contralateral normal hemispheres at the 1st and the 4th h were significantly lower in the dehydration group (p = 0.027 and 0.040, respectively).Conclusions: Our findings suggested that dehydration status is associated with the progression of infarct volume and decreases in cerebral blood flow during the acute stage of ischemic stroke. This preliminary study provided an imaging clue that more intensive hydration therapies and reperfusion strategies are necessary for the management of acute ischemic stroke patients with dehydration status.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Effects of Dehydration on Brain Perfusion and Infarct Core After Acute Middle Cerebral Artery Occlusion in Rats: Evidence From High-Field Magnetic Resonance Imaging

et al. 2018

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“…The results demonstrate that early rehydration could reduce the high mortality rate of dehydrated ischemic rats, decrease infarct volume, and improve delay time and Tmax in the ischemic hemisphere. By adding a imaging evidence, this finding extends previously reported work indicating that hydration therapy is important in acute stroke management for patients with dehydration [8,9,19,20].…”

Section: Discussionsupporting

confidence: 85%

“…Dehydration has a high prevalence in ischemic stroke and is associated with strokein-evolution and functional outcome [1][2][3][4]. The reasons for these observations are based on the concept that dehydrated status may reduce brain perfusion, decrease collateral blood flow, and aggravate ischemic brain injury [5][6][7][8]. Current acute stroke guidelines recommend rehydration for patients who are under dehydrated situations [9].…”

Section: Introductionmentioning

confidence: 99%

Effects of Early Rehydration on Brain Perfusion and Infarct Core after Middle Cerebral Artery Occlusion in Rats

Tsai

Lee

et al. 2021

Brain Sciences

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Imaging evidence for the effect of rehydration on cerebral perfusion and brain ischemia has never been proposed in the literature. This study aimed to test the hypothesis that early rehydration treatment can improve cerebral perfusion and decrease infarct volume, consequently reducing mortality of dehydrated stroke animals. Methods: Thirty dehydrated experimental rats were randomly assigned to either a rehydration or control group after middle cerebral artery occlusion (MCAO). Diffusion-weighted imaging and dynamic contrast enhancement perfusion imaging were performed at 30 min and 6 h after MCAO using a 9.4T MR imaging scanner to measure the infarct volume and brain perfusion. Results: The survival rates after the first MRI scan were 91.7% for the rehydration group and 58.3% for the control group (p = 0.059). The survival rates after the second MRI scan were 66.7% for the rehydration group, and 8.3% of the control group survived (p = 0.003). The infarct volume of the rehydration group was significantly smaller than control group at 30 min after MCAO (p = 0.007). The delay time and time to maximum were significantly shorter in the rehydration group at 30 min (p = 0.004 and 0.035, respectively). Conclusions: The findings suggest that early rehydration therapy can decrease the infarct volume, shorten the delay time of cerebral perfusion, and increase survival of dehydrated ischemic-stroke rats. This preliminary study provided imaging evidence that more intensive early hydration therapies and reperfusion strategies may be necessary for acute stroke patients with dehydrated status.

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Priority Nursing Interventions Caring for the Stroke Patient

Amatangelo

Thomas

2020

Critical Care Nursing Clinics of North America

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A randomized controlled study of intravenous fluid in acute ischemic stroke

Cited by 6 publications

References 17 publications

Effects of Dehydration on Brain Perfusion and Infarct Core After Acute Middle Cerebral Artery Occlusion in Rats: Evidence From High-Field Magnetic Resonance Imaging

Effects of Dehydration on Brain Perfusion and Infarct Core After Acute Middle Cerebral Artery Occlusion in Rats: Evidence From High-Field Magnetic Resonance Imaging

Effects of Early Rehydration on Brain Perfusion and Infarct Core after Middle Cerebral Artery Occlusion in Rats

Priority Nursing Interventions Caring for the Stroke Patient

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