Association of oxygenation levels after successful mechanical thrombectomy under general anesthesia and 3-month functional outcome in patients with acute ischemic stroke: A prospective observational study.

Abstract

Background: This study aimed to evaluate whether oxygenation levels (PaO₂ <150 mmHg vs. PaO₂ ≥150 mmHg) in mechanically ventilated patients with acute ischemic stroke (AIS) after successful endovascular treatment (EVT) under general anesthesia are associated with functional outcomes at three months.

Methods: We prospectively collected data over 30 months from patients with proximal occlusion of the anterior circulation treated with successful EVT under general anesthesia. After the procedure, patients were admitted to the ICU for delayed extubation. Two groups were established based on the partial pressure of oxygen (PaO₂ <150 mmHg vs. PaO₂ ≥150 mmHg), measured in arterial blood gas analysis within the first hour of ICU admission. Demographics, clinical factors, and neurological status were compared. The primary outcome was the proportion of patients achieving a favorable functional outcome (mRS ≤ 2) at 3 months.

Results: During the study period, 271 patients were admitted to our ICU after EVT for AIS. Of these, 210 patients met the inclusion criteria. No significant differences were found between the groups in demographics, clinical factors, neurological status, or functional outcomes at 3 months. The primary outcome showed no significant difference: 48 of 100 patients (48%) in the PaO₂ <150 mmHg group achieved a favorable functional outcome (mRS 0-2) compared to 56 of 108 patients (51.9%) in the PaO₂ ≥150 mmHg group (p = 0.579).

Conclusion: No association was found between 3-month functional outcomes and post-procedure oxygenation levels in patients with AIS treated successfully with EVT under general anesthesia.