Head position and cerebral blood flow in acute ischemic stroke patients: Protocol for the pilot phase, cluster randomized, Head Position in Acute Ischemic Stroke Trial (HeadPoST pilot)

International Journal of Stroke : Official Journal of the International Stroke Society
Alejandro M BrunserVerónica V Olavarría

Abstract

Few proven interventions exist for acute ischemic stroke (AIS), and most are expensive and restricted in applicability. Lying flat 'head down' positioning of AIS patients has been shown to increase by as much as 20%, mean cerebral blood flow velocities (CBFV) measured by transcranial Doppler (TCD) but whether this translates into clinical improvement is uncertain. To determine if the lying flat position increases mean CBFV in the affected territory as compared to the sitting up position in AIS patients. Head Position in Acute Ischemic Stroke Trial (HeadPoST pilot) is a cluster randomized (clusters being months), assessor-blinded end-point, phase IIb trial, where consecutive adults with anterior circulation AIS within 12 h of symptom onset are positioned to a randomized position for 48 h with TCD performed serially. Primary outcome is mean CBFV on TCD at 1 and 24 h after positioning. Secondary outcomes include: serious adverse events, neurological impairment at seven days, and death and disability at 90 days. Assuming an increase of 8.3 (SD 11.4) cm/s in average of mean CBFV when tilted from 30° to 0°, 46 clusters are required (92 patients in total) to detect a 20% increase of mean CBFV with 90% power and 5% level of significanc...Continue Reading

Associated Clinical Trials

Oct 15, 2012·Veronica Olavarria

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Citations

Oct 16, 2016·International Journal of Stroke : Official Journal of the International Stroke Society·Verónica V OlavarríaUNKNOWN HEADPOST Pilot Investigators
Jul 22, 2017·International Journal of Stroke : Official Journal of the International Stroke Society·Laurent BillotCraig S Anderson
May 26, 2017·International nursing review·Pamela H Mitchell
Dec 22, 2016·Neurocritical Care·Brian F Olkowski, Syed Omar Shah
Jun 6, 2017·International Journal of Stroke : Official Journal of the International Stroke Society·Verónica V OlavarríaAlejandro M Brunser
Sep 20, 2018·Current Neurology and Neuroscience Reports·Paula Muñoz VenturelliPhilip M Bath

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Clinical Trials Mentioned

NCT01706094

Software Mentioned

Research Electronic Data Capture ( REDCap )
HeadPoST
QuickCalcs
PASS

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