Efficacy and safety of normobaric hyperoxia combined with intravenous thrombolysis on acute ischemic stroke patients

ABSTRACT

Intravenous thrombolysis elevates the prognostic level of acute ischemic stroke (AIS) patients. Normobaric hyperoxia (NBO) delays the progression of the infarct core and promotes neurological recovery. However, it is uncertain whether NBO can further raise the prognostic level of AIS patients based on intravenous thrombolysis. To explore the efficacy and safety of NBO combined with intravenous thrombolysis on AIS patients. This observational study included anterior circulation stroke patients who received intravenous thrombolysis within 4.5 h after stroke onset. These patients were divided into two groups based on whether or not they received NBO therapy. The baseline data and the prognosis of the two groups were compared. The primary outcome was the proportion of functional independence (modified Rankin Scale 0–2) at 90 days post discharge. A total of 227 patients were included in this study. 125 patients received NBO therapy combined with intravenous thrombolysis, while 102 patients received intravenous thrombolysis only. Overall, the rate of recanalization was 83.3%. Consequently, 101 patients (80.8%) who received NBO combined with intravenous thrombolysis and 63 patients (61.8%) in the control group achieved functional independence (P = 0.002). Multivariable logistic regression analysis showed that NBO combined with intravenous thrombolysis over intravenous thrombolysis alone was associated with 90-day functional independence (OR: 2.318; 95% CI: 1.226–4.381; P = 0.01). This study verified the efficacy and safety of NBO combined with intravenous thrombolysis in AIS patients. Prospective study is needed to further substantiate these findings.

KEYWORDS:

• Stroke
• intravenous thrombolysis
• normobaric hyperoxia
• neuroprotection
• outcome

Acknowledgments

The authors appreciate substantial help in statistics from Dr. Weifeng Yin and Dr. Chengbei Hou from the Center for Evidence Based Medicine of Xuanwu Hospital of Capital Medical University.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was supported by National Natural Science Foundation of China (81620108011).

Notes on contributors

Na Li

Na Li did her MD at Xuanwu hospital of Capital Medical University (China). She participates in the National Natural Science Foundation of China (81620108011). She mainly investigates neuroprotection and intravenous thrombolysis therapy for acute ischemic stroke patients. She is also a neurologist at Xuanwu hospital.

Longfei Wu

Longfei Wu did his MD at Xuanwu hospital of Capital Medical University (China). He participates in the National Key Research and Development Program of China (2016YFC1301502) and National Science Foundation of China (81771260). He mainly investigates neuroprotection and endovascular therapy for acute ischemic stroke patients and has published many articles in these fields.

Wenbo Zhao

Wenbo Zhao is a neurologist at Xuanwu hospital. He participates in the National Key Research and Development Program of China (2016YFC1301502) and National Science Foundation of China (81771260). His major research is cerebrovascular disease. He has published many articles in the field of neuroprotection (such as remote preconditioning).

David Dornbos

David Dornbos III works in the Department of Neurological Surgery, Semmes-Murphey Clinic and University of Tennessee Health Science Center. He is interested in cerebrovascular disease.

Chuanjie Wu

Chuanjie Wu is a neurologist at Xuanwu hospital. He participates in the National Key Research and Development Program of China (2016YFC1301502). His major research is cerebrovascular disease. He has published many articles in the field of neuroprotection (such as hypothermia).

Weili Li

Weili Li did his MD at Xuanwu hospital of Capital Medical University (China). He mainly investigates neuroprotection for acute ischemic stroke patients.

Di Wu

Di Wu is a researcher at Xuanwu hospital of Capital Medical University (China). His major research is clinical translation of neuroprotection. He has published many articles in this field.

Jianping Ding

Jianping Ding is a neurologist at Xuanwu hospital. She has extensive experience in the treatment of stroke.

Yuchuan Ding

Yuchuan Ding is a professor at Wayne State University School of Medicine (USA). He has published many articles on cerebrovascular diseases.

Yunyan Xie

Yunyan Xie is a neurologist at Xuanwu hospital. Her major research field is cerebrovascular disease.

Xunming Ji

Xunming Ji is the vice-president of Capital Medical University (China). He is also an expert in the field of stroke and Changjiang scholar in China. He has published widely on the valuable therapeutic approaches (such as remote preconditioning and normobaric oxygen). Professor Ji advocates the use of neuroprotection in the treatment of stroke patients to further improve patient outcomes.