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Extubation after thrombectomy: the sooner, the better

Early extubation (within 6 hours) after thrombectomy in stroke patients independently predicts favourable outcome at 3 months, compared to extubation between 6 and 24 hours. Furthermore, pneumonia rates and duration of stay in the neurointensive care unit/stroke unit were reduced. Ventilation in these patients should therefore be shortened as much as safely possible.

In a single-centre study, researchers from the Medical University of Graz (Austria) aimed to assess the clinical impact of the duration of artificial ventilation in stroke patients receiving mechanical thrombectomy (MT) under general anaesthesia [1]. They identified all ischaemic stroke patients who had received MT for anterior circulation large vessel occlusion under general anaesthesia over a period of 8 years (n=447). There patients were divided into 3 groups, according to ventilation timing: “early” (extubation within 6 hours), “delayed” (6-24 hours), and “late” (>24 hours).

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