Enhanced versus standard hydration in acute ischemic stroke: REVIVE-A randomized clinical trial.

التفاصيل البيبلوغرافية
العنوان:	Enhanced versus standard hydration in acute ischemic stroke: REVIVE-A randomized clinical trial.
المؤلفون:	Lin LC; Department of Emergency Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan.; Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan., Lee TH; Stroke Center and Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.; College of Medicine, Chang Gung University, Taoyuan, Taiwan., Huang YC; College of Medicine, Chang Gung University, Taoyuan, Taiwan.; Department of Neurology, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan., Tsai YH; College of Medicine, Chang Gung University, Taoyuan, Taiwan.; Department of Diagnostic Radiology, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan., Yang JT; College of Medicine, Chang Gung University, Taoyuan, Taiwan.; Department of Neurosurgery, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan., Yang LY; Biostatistics Unit, Clinical Trial Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan., Pan YB; Biostatistics Unit, Clinical Trial Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan., Lee M; College of Medicine, Chang Gung University, Taoyuan, Taiwan.; Department of Neurology, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan., Chen KF; College of Medicine, Chang Gung University, Taoyuan, Taiwan.; Department of Emergency Medicine, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan., Hung YC; Department of Emergency Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan., Cheng HH; Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan., Lee IN; Department of Medical Research and Development, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan., Lee MH; Department of Neurosurgery, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan., Chiu T; Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan., Chang YJ; Stroke Center and Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.; College of Medicine, Chang Gung University, Taoyuan, Taiwan., Goh ZNL; Wesfarmers Centre for Vaccines & Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia.; UWA Centre for Child Health Research, UWA Medical School, The University of Western Australia, Perth, WA, Australia.; Department of Emergency Medicine, New Taipei Municipal Tucheng Hospital, New Taipei City, Taiwan., Seak CJ; College of Medicine, Chang Gung University, Taoyuan, Taiwan.; Department of Emergency Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.; Department of Emergency Medicine, New Taipei Municipal Tucheng Hospital, New Taipei City, Taiwan.
المصدر:	International journal of stroke : official journal of the International Stroke Society [Int J Stroke] 2024 Jul 31, pp. 17474930241259940. Date of Electronic Publication: 2024 Jul 31.
Publication Model:	Ahead of Print
نوع المنشور:	Journal Article
اللغة:	English
بيانات الدورية:	Publisher: SAGE Publications Country of Publication: United States NLM ID: 101274068 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1747-4949 (Electronic) Linking ISSN: 17474930 NLM ISO Abbreviation: Int J Stroke Subsets: MEDLINE
أسماء مطبوعة:	Publication: 2016- : Thousand Oaks, CA : SAGE Publications Original Publication: Oxford, UK : Blackwell Pub., c2005-
مستخلص:	Rationale: Early neurological deterioration (END) within 72 h of stroke onset is associated with poor prognosis. Optimizing hydration might reduce the risk of END. Aims: This study aimed to determine in acute ischemic stroke patients if enhanced hydration versus standard hydration reduced the incidence of major (primary) and minor (secondary) END, as well as whether it increased the incidence of early neurological improvement (secondary), at 72 h after admission. Sample Size Estimate: A total of 244 participants per arm. Methods and Design: A prospective, double-blinded, multicenter, parallel-group, randomized controlled trial conducted at four hospitals from April 2014 to July 2020, with data analyzed in August 2020. The sample size estimated was 488 participants (244 per arm). Ischemic stroke patients with measurable neurological deficits of onset within 12 h of emergency department presentation and blood urea nitrogen/creatinine (BUN/Cr) ratio ⩾ 15 at point of admission were enrolled and randomized to 0.9% sodium chloride infusions of varying rates-enhanced hydration (20 mL/kg body weight, one-third given via bolus and remainder over 8 h) versus standard hydration (60 mL/h for 8 h), followed by maintenance infusion of 40-80 mL/h for the subsequent 64 h. The primary outcome measure was the incidence of major END at 72 h after admission, defined as an increase in National Institutes of Health Stroke Scale of ⩾ 4 points from baseline. Results: Overall, 487 participants were randomized (median age 67 years; 287 females). At 72 h, 7 (2.9%) in the enhanced hydration arm and 5 (2.0%) in the standard hydration developed major END (p = 0.54). The incidence of minor END and early neurological improvement did not differ between treatment arms. Conclusion and Relevance: Enhanced hydration did not reduce END or improve short-term outcomes in acute ischemic stroke. Trial Registration: ClinicalTrials.gov (NCT02099383, https://clinicaltrials.gov/study/NCT02099383). Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
فهرسة مساهمة:	Keywords: Acute ischemic stroke; early neurologic improvement; early neurological deterioration; early neurological improvement; hydration therapy; stroke etiology; time from stroke onset to treatment
سلسلة جزيئية:	ClinicalTrials.gov NCT02099383
تواريخ الأحداث:	Date Created: 20240524 Latest Revision: 20240731
رمز التحديث:	20240731
DOI:	10.1177/17474930241259940
PMID:	38785314
قاعدة البيانات:	MEDLINE

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تدمد:	1747-4949
DOI:	10.1177/17474930241259940