Noninvasive Ventilatory Correction in Patients With Acute Ischemic Stroke A Systematic Review and Meta-Analysis

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216224%3A14110%2F17%3A00113821" target="_blank" >RIV/00216224:14110/17:00113821 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00159816:_____/17:00067086

Výsledek na webu

<a href="https://www.ahajournals.org/doi/10.1161/STROKEAHA.117.017661" target="_blank" >https://www.ahajournals.org/doi/10.1161/STROKEAHA.117.017661</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1161/STROKEAHA.117.017661" target="_blank" >10.1161/STROKEAHA.117.017661</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Noninvasive Ventilatory Correction in Patients With Acute Ischemic Stroke A Systematic Review and Meta-Analysis

Popis výsledku v původním jazyce

Background and Purpose-Even though current guidelines suggest that noninvasive ventilatory correction (NIVC) could be considered for acute ischemic stroke patients with obstructive sleep apnea, available evidence is conflicting, with no adequately powered randomized clinical trial being available to date. Methods-We conducted a systematic review and meta-analysis of all available literature data evaluating the effect of NIVC on neurological improvement (based on decrease in National Institutes of Health Stroke Scale score), vascular events (recurrent stroke, transient ischemic attack, myocardial infarction and unstable angina), and mortality during the followup period. Results-We identified 4 randomized clinical trials and 1 prospectively matched observational cohort, comprising a total of 389 patients (59.8% males, mean age: 64.4 years). The risk of both performance and detection bias was considered high in most of the included randomized clinical trials because of the lack of blinding in participants, personnel and/ or outcome assessors. The mean decrease in National Institutes of Health Stroke Scale scores during the first (&lt;= 30) days of acute ischemic stroke was found to be greater in NIVC-treated patients in comparison to controls (standardized mean difference, 0.38; 95% confidence interval, 0.11-0.66; P= 0.007). However, no significant differences were detected between NIVC-treated acute ischemic stroke patients and controls on both the risk of vascular events (risk ratio, 0.53; 95% confidence interval, 0.25-1.14; P= 0.11) and mortality (risk ratio, 0.71; 95% confidence interval, 0.37-1.36; P= 0.30). No evidence of heterogeneity (I2= 0%; P for Cochran Q&gt; 0.50) or publication bias were detected in all analyses. Conclusions-NIVC seems to be associated with greater short-term neurological improvement in acute ischemic stroke patients with obstructive sleep apnea. This finding deserves further investigation within the settings of an adequately powered, sham-control, randomized clinical trial.

Název v anglickém jazyce

Noninvasive Ventilatory Correction in Patients With Acute Ischemic Stroke A Systematic Review and Meta-Analysis

Popis výsledku anglicky

Background and Purpose-Even though current guidelines suggest that noninvasive ventilatory correction (NIVC) could be considered for acute ischemic stroke patients with obstructive sleep apnea, available evidence is conflicting, with no adequately powered randomized clinical trial being available to date. Methods-We conducted a systematic review and meta-analysis of all available literature data evaluating the effect of NIVC on neurological improvement (based on decrease in National Institutes of Health Stroke Scale score), vascular events (recurrent stroke, transient ischemic attack, myocardial infarction and unstable angina), and mortality during the followup period. Results-We identified 4 randomized clinical trials and 1 prospectively matched observational cohort, comprising a total of 389 patients (59.8% males, mean age: 64.4 years). The risk of both performance and detection bias was considered high in most of the included randomized clinical trials because of the lack of blinding in participants, personnel and/ or outcome assessors. The mean decrease in National Institutes of Health Stroke Scale scores during the first (&lt;= 30) days of acute ischemic stroke was found to be greater in NIVC-treated patients in comparison to controls (standardized mean difference, 0.38; 95% confidence interval, 0.11-0.66; P= 0.007). However, no significant differences were detected between NIVC-treated acute ischemic stroke patients and controls on both the risk of vascular events (risk ratio, 0.53; 95% confidence interval, 0.25-1.14; P= 0.11) and mortality (risk ratio, 0.71; 95% confidence interval, 0.37-1.36; P= 0.30). No evidence of heterogeneity (I2= 0%; P for Cochran Q&gt; 0.50) or publication bias were detected in all analyses. Conclusions-NIVC seems to be associated with greater short-term neurological improvement in acute ischemic stroke patients with obstructive sleep apnea. This finding deserves further investigation within the settings of an adequately powered, sham-control, randomized clinical trial.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30210 - Clinical neurology

Projekt

Výsledek vznikl pri realizaci vícero projektů. Více informací v záložce Projekty.

Návaznosti

P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)<br>I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2017

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Stroke

ISSN

0039-2499

e-ISSN

—

Svazek periodika

48

Číslo periodika v rámci svazku

8

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

4

Strana od-do

2285-2288

Kód UT WoS článku

000406128300063

EID výsledku v databázi Scopus

2-s2.0-85020660809