Abstract 3710: Nasal Continuous Positive Airway Pressure Therapy In Acute Stroke: Results Of A Feasibility Study
Introduction: Sleep related breathing disorder (SRBD) is a frequent complication in the early phase after stroke. SRBD is associated with poor outcome. Continuous positive airway pressure (CPAP) was shown to be feasible and to improve outcome when applied in the chronic phase after stroke. We hypothesized that CPAP therapy initiation in the first night after stroke is feasible.
Methods: In this open-label, parallel group study with blind assessment of outcomes 50 patients were randomly assigned to the CPAP or the control group. Intervention patients received CPAP therapy for three nights. Patients of the CPAP group with an apnea-hypopnea index (AHI)>10/hour as measured by polysomnography (PSG) at night four were treated with CPAP for additional four nights. The primary end point was feasibility defined by reduction in AHI with CPAP treatment, CPAP adherence and nursing workload within the first three nights. The secondary end point was NIHSS score improvement on day eight.
Results: Under CPAP treatment the AHI was significantly reduced (P=0.0001). Nursing work load was similar between the CPAP (n=25) and the control group (n=25) (P=0.741). Ten patients (40.0 %) had excellent CPAP use, 14 patients (56.0 %) had some use, and 1 patient (4.0 %) had no use. We found a trend towards greater NIHSS score improvement in the CPAP group (P=0.092) and a significantly greater NIHSS score improvement in patients with excellent CPAP use (P = 0.022) when compared to the control group.
Conclusions: This is the first randomized trial that investigated the feasibility of CPAP therapy in acute stroke patients. Compliance was moderate without increasing the nursing workload. CPAP significantly reduced the AHI and might thereby improve clinical outcome after stroke. Our findings warrant further investigation in a larger trial.
- © 2012 by American Heart Association, Inc.