Title: Mechanical Ventilation of the Patient with Acute Ischemic Stroke<br/>Author: Mike Winters<br/><a href='http://umem.org/profiles/faculty/141/'>[Click to email author]</a><hr/><p>
<strong><u>Mechanical Ventilation Pearls for Acute Ischemic Stroke</u></strong></p>
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Patients with an acute ischemic stroke (AIS) may require intubation for various reasons.</li>
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Two main goals of mechanical ventilation in patients with an AIS are to <u>maintain appropriate oxygen levels</u> and <u>tight control of PaCO2</u>.</li>
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In terms of oxygenation:
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Target <strong>normoxia</strong></li>
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Administer O2 if the SpO2 is < 94%</li>
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Supplemental O2 is not recommended in non-hypoxic patients</li>
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In terms of CO2:
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Target <strong>normocapnia</strong></li>
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Hypercapnia increases the risk of intracranial hypertension</li>
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Hypocapnia can worsen cerebral perfusion</li>
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<fieldset><legend>References</legend>
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Robba C, et al. Mechanical ventilation in patients with acute ischemic stroke: from pathophysiology to clinical practice. <em>Crit Care.</em> 2019;23:388.</p>
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