Primary 'dehydration' and acute stroke: a systematic research review

被引:39
作者
Bahouth, Mona N. [1 ,2 ]
Gottesman, R. F. [1 ]
Szanton, S. L. [2 ,3 ]
机构
[1] Johns Hopkins Sch Med, Dept Neurol, 600 N Wolfe St,Phipps 486, Baltimore, MD 21287 USA
[2] Johns Hopkins Sch Nursing, Baltimore, MD 21205 USA
[3] Johns Hopkins Bloomberg Sch Publ Hlth, Baltimore, MD USA
关键词
Dehydration; Acute stroke; Early recovery; Rehydration; EARLY NEUROLOGICAL DETERIORATION; UREA NITROGEN/CREATININE RATIO; URINE SPECIFIC-GRAVITY; ACUTE ISCHEMIC-STROKE; FLUID INTAKE; HYDRATION THERAPY; BLOOD-VISCOSITY; BARTHEL INDEX; REHABILITATION; PREDICTORS;
D O I
10.1007/s00415-018-8799-6
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Hydration status at the time of stroke has been acknowledged as an important determinant in early stroke recovery. However, the diagnosis of dehydration, or more accurately, a volume-contracted state, at the time of stroke is challenging since there are currently no consensus diagnostic criteria. In this systematic review, we gather the available evidence about diagnosis and treatment of dehydration after stroke. Studies of hospitalized ischemic stroke patients that reported rates of dehydration from January 1997 to March 2017 were screened for inclusion via a systematic search of PubMed, CINAHL, Cochrane, and Scopus using keywords hydration, dehydration, hemodilution, viscosity, volume status, and thirst. Twenty-five studies of 8699 acute stroke patients were included. Nineteen studies reported on the diagnostic approach to dehydration. Findings are synthesized into four main categories of available research including studies that specify: (1) biological mechanisms using animal models to investigate the relationship between dehydration and stroke; (2) measures of dehydration in the acute human stroke population; (3) rehydration therapies after stroke; and (4) outcomes after stroke in dehydrated patients. We found considerable variation in terminology specific to hydration status, diagnostic approach to dehydration, and few prospective studies of treatment strategies with varying results. This review supports the need for consensus development of operational diagnostic criteria, standardization of language, and the opportunity for prospective study of rehydration strategies to impact outcome after stroke.
引用
收藏
页码:2167 / 2181
页数:15
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