Continuous pulse oximetry in acute hemiparetic stroke

Abstract

Background and purpose: Hypoxemia can adversely affect ischemic brain tissue in laboratory animals. The aim of this study was to assess the value of early continuous monitoring with pulse oximetry in detecting arterial oxygen desaturations in patients with acute hemiparetic stroke, and the effects of oxygen administration.

Methods: Over a period of 6 months 49 consecutive patients with acute hemiparetic stroke of </=12 h duration were monitored for the first 48 h with pulse oximetry. Patients in whom arterial oxygen saturation (SaO(2)) fell beneath 96% for a period longer than 5 min were treated with oxygen administered via nasal prongs or oxygen mask.

Results: Thirty-one patients (63.3%) developed arterial oxygen desaturations. Of these patients 28 could effectively be treated with oxygen up to a flow-rate of 5 l/min. Only 3 patients required higher oxygen concentrations from 6 to 10 l/min. No acute adverse effects of oxygen treatment were observed. All patients with a history of cardiac and pulmonary disease developed drops in SaO(2). The occurrence of arterial oxygen desaturations was related to stroke severity (P=0.024), the presence of dysphagia (P=0.047), and older age (P=0.037).

Conclusion: Patients with acute hemiparetic stroke frequently develop arterial oxygen desaturations. Continuous monitoring with pulse oximetry in this group of patients is a simple and useful method to detect drops in SaO(2) and to titrate oxygen administration.