This Article Full Text Full Text (PDF) All Versions of this Article: 36/1/171    most recent 01.STR.0000149614.84492.29v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Righetti, E. Articles by Ricci, S. Search for Related Content PubMed Articles by Righetti, E. Articles by Ricci, S. Related Collections Acute Cerebral Hemorrhage Acute Cerebral Infarction Other Stroke Treatment - Medical

(Stroke. 2005;36:171.)
© 2005 American Heart Association, Inc.

Cochrane Corner

Glycerol for Acute Stroke

Enrico Righetti, MD; Maria Grazia Celani, MD; Teresa Anna Cantisani, MD; Roberto Sterzi, MD; Gudrun Boysen, MD Stefano Ricci, MD

Correspondence to Enrico Righetti, Stroke Service, USL 2 Via Cestellini, 06087 Ponte San Giovanni, Perugia, Italy. E-mail istitaly@unipg.it

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Brain edema is a major cause of early death after stroke, but no treatment has been shown to be effective, and recommendations in American and European guidelines are based only on expert opinion. A 10% solution of glycerol is a hyperosmolar agent that is claimed to reduce brain edema, and its use has been (and probably still is) rather popular in some countries (Italy, Poland, China).

Objectives

The objectives of this study were to determine whether intravenous glycerol treatment in acute stroke, either ischemic or hemorrhagic, influences death rates and functional outcome in the short-term or long-term, and whether the treatment is safe.

Search Strategy

The Cochrane Stroke Group trials register was searched (January 2003). Some trialists were personally contacted.

Selection Criteria

All completed, randomized and quasi-randomized, controlled, published, and unpublished comparisons evaluating clinical outcome in which intravenous glycerol treatment was initiated within the first days after stroke onset were used.

Data Collection and Analysis

Two reviewers independently applied the inclusion criteria, assessed the trial quality, and extracted data, and the data were checked with all co-reviewers. Death from all causes, functional outcome, and adverse effects were analyzed.

Main Results

Eleven completed randomized trials comparing intravenous glycerol and control treatments were considered. Analysis of death during the scheduled treatment period for acute ischemic and/or hemorrhagic stroke was possible in 10 trials in which 482 glycerol-treated patients were compared with 463 control patients. Glycerol was associated with a nonsignificant reduction in the odds of death within the scheduled treatment period (odds ratio [OR], 0.78; 95% confidence interval [CI], 0.58 to 1.06). Among . . . [Full Text of this Article]