Assessment of volemic status in acute period of ischemic stroke

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OBJECTIVE

To assess volemic status of patients in acute period of ischemic stroke (IS) using laboratory and instrumental parameters as predictors of outcomes.

MATERIAL AND METHODS

We enrolled 186 patients with CT/MRI-verified IS within 24 hours after clinical manifestation and 20 healthy persons (control group). Laboratory (serum sodium and brain natriuretic peptide) and instrumental parameters (left ventricular end-diastolic volume, left ventricular ejection fraction, IVC diameter and degree of inspiratory collapse) were used to assess volemic status. Clinical course of IS was assessed using conventional scales (NIHSS, Rivermead and Rankin scales). Life prognosis was evaluated over time.

RESULTS

There were significant disorders of volemic status mainly in patients with atherothrombotic and cardioembolic IS according to NT-proBNP, LV EDV, IVC diameter, LV EF and degree of IVC collapse. These disorders significantly correlated with age, arterial blood pressure and clinical indicators of severity of neurological damage. The highest mortality was observed in patients with baseline volemic disorders (78%).

CONCLUSION

Laboratory and instrumental parameters characterize impairment of volemic status associated with severity of neurological damage.

Keywords:

volemic status

ischemic stroke

NT-proBNP

sodium

left ventricular end-diastolic volume

ejection fraction

inferior vena cava diameter

Authors:

Mikhailov E.V.

Central Clinical Hospital with Polyclinic of Administrative Directorate of the President of the Russian Federation

ORCID: 0009-0001-6696-9020

Pasechnik I.N.

Central State Medical Academy of Administrative Directorate of the President of the Russian Federation

ORCID: 0000-0002-8121-4160

Korochkina G.V.

Central Clinical Hospital with Polyclinic of Administrative Directorate of the President of the Russian Federation

ORCID: 0009-0007-5530-0827

Received:

06.03.2024

Accepted:

08.04.2024

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