19
4.2. Head Positioning
COR LOE
Recommendations
3: No
benefit
B-R
1. In patients with AIS overall, there is no benefit of routine
0-degree head positioning compared with 30 degrees for
24 hours, to improve functional outcome.
3: No
benefit
B-R
2. In patients with AIS with probable large artery atherosclerosis
cause for whom no reperfusion intervention is available, there
is no benefit of routine Trendelenburg positioning
(−20 degrees) compared with 0- to-30- degree head
positioning to improve functional outcome.
4.1. Airway, Breathing, and Oxygenation
COR LOE
Recommendations
1 C-LD
1. In patients with acute stroke and decreased consciousness or
bulbar dysfunction, airway support and ventilatory assistance
are recommended as needed to provide airway maintenance,
protection and adequate ventilation and oxygenation.
1 C-LD
2. In patients with AIS with hypoxia, supplemental oxygen should
be provided to maintain oxygen saturation (SpO
2
) >94%.
2b B-R
3. In patients with AIS within 6 hours from onset, NIHSS
score 10 to 20, CT ASPECTS of ≥6, and anterior circulation
LVO (M1 or carotid terminus) with planned EVT (with or
without IVT) normobaric hyperoxia (NBO) before EVT
may be reasonable to improve functional outcomes at 90 days.
2b B-NR
4. In patients with AIS due to arterial air embolism, hyperbaric
oxygen (HBO) may be reasonable to improve clinical outcome.
3: No
benefit
B-R
5. In patients with AIS without hypoxia who are ineligible for
EVT, supplemental oxygen is not recommended to improve
functional outcomes.
3: No
benefit
B-R
6. In patients with AIS, not associated with air embolism, HBO
is not recommended to improve functional outcomes.
General Supportive Early Management
