Acceptance, effectiveness and safety of continuous positive airway pressure in acute stroke: A pilot study

SummaryObjectivesTo evaluate the acceptance, effectiveness in preventing upper airways obstruction, and haemodynamic effects of continuous positive airway pressure (CPAP) in acute stroke.MethodsTwelve patients (4 M, and 8 F; mean (SD), 75.2 (5.5) years) within 48h of acute stroke onset underwent: (1) sleep studies (1st night: auto-CPAP mode; 2nd night: diagnostic); (2) nocturnal non-invasive blood pressure studies (1st night during CPAP; 2nd night during spontaneous breathing (SB)); and (3) daytime cerebral blood flow velocity measurement in middle cerebral artery (FV) with transcranial Doppler during SB and with CPAP (5, 10, 15cmH2O).ResultsNinety percent, 60% and 50% of stroke patients had a respiratory disturbance index (RDI) of ≥5, ≥10 and ≥15 events per hour, respectively (18.2 (11.3)). CPAP acceptance was 84%; 42% used CPAP more than 6h and 42% between 1–3h with a mean use of CPAP of 5.2h (4.0). Compared to SB, CPAP reduced, though not significantly, RDI, time with SaO2