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Early treatment of obstructive apnoea and stroke outcome: a randomised controlled trial

O. Parra, Á. Sánchez-Armengol, M. Bonnin, A. Arboix, F. Campos-Rodríguez, J. Pérez-Ronchel, J. Durán-Cantolla, G. de la Torre, J.R. González Marcos, M. de la Peña, M. Carmen Jiménez, F. Masa, I. Casado, M. Luz Alonso, J.L. Macarrón
European Respiratory Journal 2011 37: 1128-1136; DOI: 10.1183/09031936.00034410
O. Parra
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  • For correspondence: oparra@ub.edu
Á. Sánchez-Armengol
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M. Bonnin
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A. Arboix
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F. Campos-Rodríguez
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J. Pérez-Ronchel
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J. Durán-Cantolla
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G. de la Torre
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J.R. González Marcos
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M. de la Peña
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M. Carmen Jiménez
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F. Masa
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I. Casado
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M. Luz Alonso
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J.L. Macarrón
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Abstract

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.

  • Cardiovascular events
  • ischaemic stroke
  • mortality
  • nasal continuous positive airway pressure
  • neurologic outcome
  • quality of life

Footnotes

  • Support Statement

    Supported in part by grants from FIS (PI08/1514, PI05/0678, PI05/2631 and PI05/0772), Madrid, Spain.

  • Clinical Trial

    This study is registered at ClinicalTrials.gov with identifier number NCT00202501.

  • Statement of Interest

    None declared.

  • Received March 4, 2010.
  • Accepted August 1, 2010.
  • ©ERS 2011
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Early treatment of obstructive apnoea and stroke outcome: a randomised controlled trial
O. Parra, Á. Sánchez-Armengol, M. Bonnin, A. Arboix, F. Campos-Rodríguez, J. Pérez-Ronchel, J. Durán-Cantolla, G. de la Torre, J.R. González Marcos, M. de la Peña, M. Carmen Jiménez, F. Masa, I. Casado, M. Luz Alonso, J.L. Macarrón
European Respiratory Journal May 2011, 37 (5) 1128-1136; DOI: 10.1183/09031936.00034410

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Early treatment of obstructive apnoea and stroke outcome: a randomised controlled trial
O. Parra, Á. Sánchez-Armengol, M. Bonnin, A. Arboix, F. Campos-Rodríguez, J. Pérez-Ronchel, J. Durán-Cantolla, G. de la Torre, J.R. González Marcos, M. de la Peña, M. Carmen Jiménez, F. Masa, I. Casado, M. Luz Alonso, J.L. Macarrón
European Respiratory Journal May 2011, 37 (5) 1128-1136; DOI: 10.1183/09031936.00034410
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