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In several articles it is reported how isvhaemic (stroke) patients’ outcome Ian improved by oxygen therapy.

How beneficial is the administration of oxygen? Are there any studies or guidelines?

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A large study of ~8000 patients suggests there is no real benefit to prophylactic oxygen supplementation after acute stroke (Roffe et al., 2017).

American Heart Association/American Stroke Association guidelines (Powers et al., 2018) are for oxygen only for hypoxic patients, with limited evidence of benefit but no evidence of harm. Hyperbaric oxygen is only recommended in cases of air embolism.

These guidelines are supported by Roffe et al., 2017, but they are consistent with the guidelines prior to that study, so this is a case where a large study confirms the standard of care rather than suggesting a shift in paradigm.


References:

Powers, W. J., Rabinstein, A. A., Ackerson, T., Adeoye, O. M., Bambakidis, N. C., Becker, K., ... & Jauch, E. C. (2018). 2018 guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 49(3), e46-e99.

Roffe, C., Nevatte, T., Sim, J., Bishop, J., Ives, N., Ferdinand, P., & Gray, R. (2017). Effect of routine low-dose oxygen supplementation on death and disability in adults with acute stroke: the stroke oxygen study randomized clinical trial. Jama, 318(12), 1125-1135.

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  • 1
    Good answer. I'd also note that there is a theoretical risk of oxygen therapy after a stroke exacerbating ischemia reperfusion injury, were that to occur. That is to say, oxygen is not without risk.
    – De Novo
    Jan 29 '19 at 18:59
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    @DeNovo Right, although I did not see any results demonstrating that harm. It could be that a small risk of harm offsets a small chance of improvement over a large study population. But I suspect that what you say is the reason that the AHA recommends against using oxygen without evidence of benefit, since supplemental oxygen isn't strictly benign. Jan 29 '19 at 19:12

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