Remote Ischemic Conditioning for Acute Stroke

医学 袖口 改良兰金量表 冲程(发动机) 随机对照试验 人口 临床试验 麻醉 物理疗法 缺血 外科 内科学 缺血性中风 机械工程 环境卫生 工程类
作者
Rolf Ankerlund Blauenfeldt,Niels Hjort,Jan Brink Valentin,Anne-Mette Homburg,Boris Modrau,Birgitte Forsom Sandal,Martin Faurholdt Gude,Kristina Dupont Hougaard,Dorte Damgaard,Marika Poulsen,Tove Diedrichsen,Marie Louise Schmitz,Paul von Weitzel-Mudersbach,Alex Alban Christensen,Krystian Figlewski,Erik Lerkevang Grove,Margrét Katrín Hreiðarsdóttir,Henning Morthorst Lassesen,Daniel Wittrock,Søren Mikkelsen
出处
期刊:JAMA [American Medical Association]
卷期号:330 (13): 1236-1236 被引量:37
标识
DOI:10.1001/jama.2023.16893
摘要

Importance Despite some promising preclinical and clinical data, it remains uncertain whether remote ischemic conditioning (RIC) with transient cycles of limb ischemia and reperfusion is an effective treatment for acute stroke. Objective To evaluate the effect of RIC when initiated in the prehospital setting and continued in the hospital on functional outcome in patients with acute stroke. Design, Setting, and Participants This was a randomized clinical trial conducted at 4 stroke centers in Denmark that included 1500 patients with prehospital stroke symptoms for less than 4 hours (enrolled March 16, 2018, to November 11, 2022; final follow-up, February 3, 2023). Intervention The intervention was delivered using an inflatable cuff on 1 upper extremity (RIC cuff pressure, ≤200 mm Hg [n = 749] and sham cuff pressure, 20 mm Hg [n = 751]). Each treatment application consisted of 5 cycles of 5 minutes of cuff inflation followed by 5 minutes of cuff deflation. Treatment was started in the ambulance and repeated at least once in the hospital and then twice daily for 7 days among a subset of participants. Main Outcomes and Measures The primary end point was improvement in functional outcome measured as a shift across the modified Rankin Scale (mRS) score (range, 0 [no symptoms] to 6 [death]) at 90 days in the target population with a final diagnosis of ischemic or hemorrhagic stroke. Results Among 1500 patients who were randomized (median age, 71 years; 591 women [41%]), 1433 (96%) completed the trial. Of these, 149 patients (10%) were diagnosed with transient ischemic attack and 382 (27%) with a stroke mimic. In the remaining 902 patients with a target diagnosis of stroke (737 [82%] with ischemic stroke and 165 [18%] with intracerebral hemorrhage), 436 underwent RIC and 466 sham treatment. The median mRS score at 90 days was 2 (IQR, 1-3) in the RIC group and 1 (IQR, 1-3) in the sham group. RIC treatment was not significantly associated with improved functional outcome at 90 days (odds ratio [OR], 0.95; 95% CI, 0.75 to 1.20, P = .67; absolute difference in median mRS score, −1; −1.7 to −0.25). In all randomized patients, there were no significant differences in the number of serious adverse events: 169 patients (23.7%) in the RIC group with 1 or more serious adverse events vs 175 patients (24.3%) in the sham group (OR, 0.97; 95% CI, 0.85 to 1.11; P = .68). Upper extremity pain during treatment and/or skin petechia occurred in 54 (7.2%) in the RIC group and 11 (1.5%) in the sham group. Conclusions and Relevance RIC initiated in the prehospital setting and continued in the hospital did not significantly improve functional outcome at 90 days in patients with acute stroke. Trial Registration ClinicalTrials.gov Identifier: NCT03481777
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
酷波er应助LJL采纳,获得10
刚刚
温柔的夜柳完成签到,获得积分10
刚刚
zhangxin150完成签到,获得积分10
刚刚
寒江孤影完成签到,获得积分10
刚刚
yue发布了新的文献求助10
3秒前
3秒前
胡须应助淼队采纳,获得30
4秒前
木木木袁袁袁完成签到,获得积分20
4秒前
寒梅恋雪完成签到,获得积分10
5秒前
自觉的凛完成签到,获得积分10
5秒前
天天快乐应助源来是洲董采纳,获得10
5秒前
75986686完成签到,获得积分10
6秒前
8秒前
学好久完成签到 ,获得积分10
9秒前
a24017完成签到,获得积分10
12秒前
YG完成签到,获得积分10
13秒前
yue完成签到,获得积分10
17秒前
淼队完成签到,获得积分10
18秒前
18秒前
落叶解三秋完成签到,获得积分10
19秒前
Crystal完成签到 ,获得积分10
22秒前
小小酥完成签到,获得积分10
22秒前
等待蚂蚁完成签到 ,获得积分10
23秒前
zgt01发布了新的文献求助10
23秒前
心心完成签到 ,获得积分10
24秒前
123完成签到,获得积分10
25秒前
温超完成签到,获得积分10
25秒前
量子星尘发布了新的文献求助10
25秒前
26秒前
27秒前
Menta1y完成签到,获得积分10
27秒前
czzlancer完成签到,获得积分10
28秒前
汶溢完成签到,获得积分10
28秒前
xsss完成签到,获得积分10
29秒前
TAN完成签到,获得积分10
29秒前
通通通发布了新的文献求助10
30秒前
liudw完成签到,获得积分10
30秒前
丹丹子完成签到 ,获得积分10
31秒前
时光完成签到,获得积分10
31秒前
32秒前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Handbook of Industrial Diamonds.Vol2 1100
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038235
求助须知:如何正确求助?哪些是违规求助? 3575992
关于积分的说明 11374009
捐赠科研通 3305760
什么是DOI,文献DOI怎么找? 1819276
邀请新用户注册赠送积分活动 892662
科研通“疑难数据库(出版商)”最低求助积分说明 815022