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Oxygen supplementation in acute stroke
Hypoxia is common following acute stroke and associated with greater mortality and neurological morbidity. The Stroke Oxygen Study, a prospective, single-blind, multicentre, randomised controlled trial compared outcome between routine low-dose oxygen therapy and usual care (oxygen delivered to achieve target saturations) during the first 3 days after an acute stroke (Roffe et al, JAMA 2017;318:1125–35). Non-hypoxic patients were randomised to receive either continuous low-dose oxygen (3L/min if saturations were <94%; 2L/min if saturations were ≥94%), nocturnal oxygen only or usual care. Outcomes were assessed at 1 week and 90 days. Primary outcome was the modified Rankin Scale (mRS) score, a measure of disability. Secondary outcomes included mortality, neurological improvement, quality of life and activities of daily living scores. There were 8003 participants included in the study. There was no demonstrable benefit of continuous or nocturnal oxygen over usual care on mRS at 90 days (OR 0.97, 95% CI 0.89 to 1.05, P=0.45 for combined oxygen groups vs control) in either the main study population or prespecified subgroups including more hypoxic (P=0.93), early presentation (P=0.47) or more severe …
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