The importance of targeted correction of volume status in the acute period in patients with ischemic stroke for the early start of physical rehabilitation
https://doi.org/10.52485/19986173_2025_2_30
Abstract
Objective. To evaluate the effectiveness of early targeted infusion therapy in patients with ischemic stroke, in combination with high-protein nutritional support calculated based on the level of urea in daily urine, in terms of reducing the time of onset of physical rehabilitation.
Materials and methods. In two comparable groups of patients with ischemic stroke, hypovolemia was corrected: in the main group, in addition to basic infusion therapy, bolus administration with orientation according to the FloTrac® system and high-protein nutrition calculated based on the level of urea in daily urine were used; the control group received basic infusion therapy according to generally accepted approaches and nutrition without priority of high protein intake. The timing of the onset of motor rehabilitation from the moment of admission and the degree of neurological deficit according to the NIHSS scale at discharge from the hospital were assessed.
Results. In the main group, rehabilitation sessions began, on average, one day earlier than in the control group; also, the main group had a lower NIHSS score at discharge.
Conclusions. Targeted correction of hypovolemia with a focus on the indicator of the increase in stroke volume during the passive leg raise test (FloTrac®) allows for earlier initiation of active physical rehabilitation and improves long-term prognosis.
Keywords
ischemic stroke,
rehabilitation in the intensive care unit,
targeted infusion therapy,
hypovolemia,
volume status
Supporting agencies: An initiative study without a conflict of interest
About the Authors
V. V. Kulakov
Central State Medical Academy of the Presidential Administration of the Russian Federation
Russian Federation
Russian Federation
Anesthesiologist and Emergency Physician
Reanimation and Intensive Care Department
121359; 15 Marshala Timoshenko St.; Moscow
R. R. Gubaydullin
Central Clinical Hospital with a Polyclinic of the Presidential Administration of the Russian Federation
Russian Federation
Russian Federation
Doctor of Medical Sciences, Associate Professor, Professor
Department of Traumatology and Orthopedics
121359; 15 Marshala Timoshenko St.; Moscow
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For citations:
Kulakov V.V., Gubaydullin R.R. The importance of targeted correction of volume status in the acute period in patients with ischemic stroke for the early start of physical rehabilitation. Transbaikalian Medical Bulletin. 2025;(2):30-38. (In Russ.) https://doi.org/10.52485/19986173_2025_2_30
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