Journal
EUROPEAN RESPIRATORY JOURNAL
Volume 37, Issue 5, Pages 1128-1136Publisher
EUROPEAN RESPIRATORY SOC JOURNALS LTD
DOI: 10.1183/09031936.00034410
Keywords
Cardiovascular events; ischaemic stroke; mortality; nasal continuous positive airway pressure; neurologic outcome; quality of life
Categories
Funding
- FIS, Madrid, Spain [PI08/1514, PI05/0678, PI05/2631, PI05/0772]
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The aim of the present study was to assess the impact of nasal continuous positive airway pressure (nCPAP) in ischaemic stroke patients followed for 2 yrs. Stroke patients with an apnoea-hypopnoea index >= 20 events.h(-1) were randomised to early nCPAP (n=71; 3-6 days after stroke onset) or conventional treatment (n=69). The Barthel Index, Canadian Scale, Rankin Scale and Short Form-36 were measured at baseline, and at 1, 3, 12 and 24 months. The percentage of patients with neurological improvement 1 month after stroke was significantly higher in the nCPAP group (Rankin scale 90.9 versus 56.3% (p < 0.01); Canadian scale 88.2 versus 72.7% (p < 0.05)). The mean time until the appearance of cardiovascular events was longer in the nCPAP group (14.9 versus 7.9 months; p=0.044), although cardiovascular event-free survival after 24 months was similar in both groups. The cardiovascular mortality rate was 0% in the nCPAP group and 4.3% in the control group (p=0.161). Early use of nCPAP seems to accelerate neurological recovery and to delay the appearance of cardiovascular events, although an improvement in patients' survival or quality of life was not shown.
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