PROOF

Penumbral Rescue by Normobaric O=O Administration in Patients With Ischaemic Stroke and Target Mismatch ProFile: A Phase II Proof-of-Concept Trial

01.01.2017 bis 31.12.2021

Ischaemic stroke (IS) is one of the most common causes of death and the most common cause of chronic disability in the western world, most significantly affecting the ageing populations of high-income countries. It is caused by an occlusion of arteries that supply blood to the brain. Disruption of blood and oxygen supply to the brain leads to neuronal death in the ischaemic core within minutes. The hypoperfused-hypooxygenated tissue surrounding the ischaemic core, the penumbra, is at high risk for infarction over time but still salvageable. Intravenous thrombolysis (IVT) and mechanical thrombectomy (TBY) facilitate early vessel recanalization and thus survival of penumbral tissue. However, as viable penumbra fades rapidly, the therapeutic time window is narrow and many eligible patients do not reach specialized stroke centres early enough. Neuroprotective “bridging” strategies, sustaining the penumbra until reperfusion, may widen the therapeutic window, making recanalization treatments accessible to more patients and improve overall IS outcomes.
As ischaemic cell death is primarily mediated by hypoxia, increasing oxygen supply to the penumbra seems THE logical approach for neuroprotection in stroke. In human beings normobaric hyperoxygenation (NBHO) is easily achieved through inhalation humidified oxygen at high flow rates (i.e. ≥40L/min) leading to an inspiratory oxygen fraction (FiO2) of near 100%.