Routine Oxygen Supplementation Irrelevant in Acute Stroke

Oxygen was given via nasal tubes at 3 L/min if baseline oxygen saturation was 93% or less, and at 2 L/min if oxygen saturation was greater than 93%. The primary outcome was modified Rankin score, as assessed at 90 days by postal questionnaire, and analyzed for a common odds ratio (OR) for a change from one disability level to the next better level.

The results showed that the unadjusted OR for a better outcome was 0.97 for oxygen versus control, and 1.03 for continuous versus nocturnal oxygen; no subgroup could be identified that exhibited any benefit from oxygen supplementation. In addition, at least one serious adverse event occurred in 13% of participants in the continuous oxygen group, 11% in the nocturnal group, and 12.1% in the control group, but no significant harms were identified. The study was published on September 26, 2017, in JAMA.

“While we have shown that giving oxygen routinely to all stroke patients makes no difference, we also know that stroke patients whose oxygen levels fall below normal levels recover less well,” said lead author Professor Christine Roffe, MD, of Keele University. “Low oxygen levels are caused by underlying airway, lung and heart problems, with the most common cause being pneumonia. Therefore we now believe that it may be more important to address the underlying cause rather than just to treat the hypoxia by administering oxygen.”

Related Links:
Keele University
North Staffordshire Combined Healthcare NHS Trust