Bun/creatinine ratio-based hydration for preventing stroke-in-evolution after acute ischemic stroke - 20/06/14
Abstract |
Background |
Blood urea nitrogen (BUN)/creatinine (Cr) ratio was recently reported to be an independent predictor of stroke-in-evolution (SIE) among patients who had suffered acute ischemic stroke. We aim to determine if providing hydration therapy to patients with a BUN/Cr ≥15 reduces the occurrence of SIE after acute ischemic stroke.
Methods |
This prospective interventional study included 189 patients (hydration group, n = 92; control group, n = 97) with acute ischemic stroke and a BUN/Cr ≥15. Hydration group received intravenous bolus (300-500 mL) saline followed by a maintenance saline infusion (40-80 mL/h for the first 72 h), while control group received maintenance saline infusion (40-60 mL/h for the first 24 h and 0-60 mL/h for 24-72 h). The study endpoint was the proportion of patients who developed SIE within the first three days of emergency department admission.
Results |
There were no significant differences in demographic or clinical characteristics between both groups. Patients in the hydration group received a significantly larger (all P < 0.001) median volume of infused saline than patients in the control group on Days 1 (2400 vs 1440 mL), 2 (1440 vs 0 mL), and 3 (1000 vs 0 mL). The proportion of patients who experienced SIE was significantly lower in the hydration group (9/92; 9.8%) compared with the control group (21/97; 21.6%) (Fig. 1, P = 0.026).
Conclusions |
Our preliminary findings suggest that providing patients with acute ischemic stroke hydration therapy on the basis of their presenting BUN/Cr ratio may help reduce the occurrence of SIE and therefore improve prognosis.
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☆ | Source of support: This work was supported by Grants CMRPG690431, CMRPG690441 and CMRPG690201 from the Chang Gung Medical Research Council. |
Vol 32 - N° 7
P. 709-712 - juillet 2014 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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