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Cited by 119Acute Ischemic Stroke ManagementThermal Regulation in MedicineStroke Rehabilitation and Recovery

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Hypoxia after stroke: a review of experimental and clinical evidence

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Ferdinand, Phillip, Roffe, Christine·2016·Experimental & Translational Stroke Medicine
DOI 10.1186/s13231-016-0023-0PMC PMC5143450
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Abstract

BACKGROUND: Hypoxia is a common occurrence following stroke and associated with poor clinical and functional outcomes. Normal oxygen physiology is a finely controlled mechanism from the oxygenation of haemoglobin in the pulmonary capillaries to its dissociation and delivery in the tissues. In no organ is this process more important than the brain, which has a number of vascular adaptions to be able to cope with a certain threshold of hypoxia, beyond which further disruption of oxygen delivery potentially leads to devastating consequences. Hypoxia following stroke is common and is often attributed to pneumonia, aspiration and respiratory muscle dysfunction, with sleep apnoea syndromes, pulmonary embolism and cardiac failure being less common but important treatable causes. As well as treating the underlying cause, oxygen therapy is a vital element to correcting hypoxia, but excessive use can itself cause molecular and clinical harm. As cerebral vascular occlusion completely obliterates oxygen delivery to its target tissue, the use of supplemental oxygen, even when not hypoxic, would seem a reasonable solution to try and correct this deficit, but to date randomised clinical trials have not shown benefit. CONCLUSION: Whilst evidence for the use of supplemental oxygen therapy is currently lacking, it is vital to rapidly identify and treat all causes of hypoxia in the acute stroke patient, as a failure to will lead to poorer clinical outcomes. The full results of a large randomised trial looking at the use of supplemental oxygen therapy are currently pending.

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Metadata

Authors
Ferdinand, P., & Roffe, C.
Affiliations
  • The Royal Wolverhampton NHS Trust (GB)
  • Keele University (GB)
Corresponding author
Ferdinand, Phillip
ORCID
Venue
Experimental & Translational Stroke Medicine
Publisher
Springer Science and Business Media LLC
Published
2016-12
Volume
8
Issue
1
Pages
9-9
ISSN
2040-7378 (ISSN-L)
DOI
10.1186/s13231-016-0023-0
PMC
PMC5143450
OpenAlex
W2560308763
Cited by
119
References
4
Citations by year
2026: 5 · 2025: 6 · 2024: 16 · 2023: 18 · 2022: 11 · 2021: 19 · 2020: 15 · 2019: 13 · 2018: 12 · 2017: 4
FWCI
1.31
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Experimental & Translational Stroke Medicine (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Keele Research Repository (Keele University) (submittedVersion, cc-by)
Funders
National Institute for Health and Care Research (PB-PG-0407-11433)
Topics
  • Health Sciences › Medicine › Clinical Neurology › Acute Ischemic Stroke Management
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Thermal Regulation in Medicine
  • Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
Keywords
hypoxia, stroke, cerebral oxygen delivery, supplemental oxygen, cerebral vascular occlusion, pneumonia, aspiration, respiratory muscle dysfunction, sleep apnea, pulmonary embolism, heart failure, stroke outcome

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