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Q J Med 2001; 94: 167-172
© 2001 Association of Physicians

Commentary

Management of acute physiological parameters after stroke

A. Bhalla, C.D.A. Wolfe and A.G. Rudd1

From the Department of Public Health Sciences, Guy's, King's and St Thomas' School of Medicine, London 1 Department of Elderly Care, Guy's and St Thomas' Hospital, London, UK

Considerable effort has been directed towards acute stroke research with numerous drug therapies being tried and tested. As yet there is still no routine treatment that is unequivocally effective in acute stroke. The development of stroke units has been a major breakthrough in reducing disability through co-ordinated rehabilitation, and new interest is being focussed towards limiting acute neurological deterioration through acute stroke units. Monitoring and attempting to stabilize acute physiological parameters within normal limits such as blood pressure, temperature, hydration status, glucose levels and oxygen saturations, has become standard practice for some acute stroke units. Strategies to correct hypertension, hypotension, dehydration, hyperglycaemia, pyrexia and hypoxia may potentially reduce neuronal damage in the acute phase of stroke and subsequently improve functional outcome and survival. Whether we require large prospective randomized controlled trials to test whether these specific interventions are to be used in mainstay practice is unclear.

Address correspondence to Dr A. Bhalla, Department of Public Health Sciences, Guy's, King's and St Thomas' School of Medicine, 42 Weston Street, London SE1 3DQ. e-mail: bhalla{at}ajay1.freeserve.co.uk


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