Does feeding alter arterial oxygen saturation in patients with acute stroke?

Rowat, A. M., Wardlaw, J. M., Dennis, M. S. and Warlow, C. P. (2000) Does feeding alter arterial oxygen saturation in patients with acute stroke? Stroke, 31(9), pp. 2134-2140. (doi: 10.1161/01.str.31.9.2134) (PMID:10978042)

Abstract

Background and Purpose—We measured arterial oxygen saturation (Sao2) during eating in acute stroke patients to establish the frequency of any meal-related hypoxemia, which could further damage already vulnerable brain tissue. Methods—Stroke patients (≤12 days from stroke onset) classified as “safe to feed orally” were compared with elderly hospitalized (for nonneurological causes) and young healthy controls. Sao2 was measured noninvasively at the bedside by pulse oximetry continuously for 10 minutes before the patient ate a meal, during the meal, and for 10 minutes after completion of the meal. Results—The median baseline Sao2 was significantly lower in stroke patients (n=106, 95.7%) than elderly (n=50, 96.7%) or young control subjects (n=20, 97.9%; P<0.001). There was a small decrease in the median Sao2 during eating in stroke and elderly patients (95.6%, P=0.08, and 96.3%, P=0.004, respectively) but not in young controls. Only stroke patients had a significantly lower median Sao2 after completion of the meal (95.4%, P<0.001). Sao2 of ≤90% during and after eating occurred in 24% of stroke and 16% of elderly patients but not in young controls, and it was significantly more common in those who had Sao2 of ≤90% during the baseline recordings (P≤0.003). Conclusions—Eating a meal was associated with a small fall in median Sao2 among stroke and elderly patients, but only in stroke patients did this persist for at least 10 minutes after eating. A quarter of stroke patients had episodes in which the Sao2 fell to ≤90% saturation (ie, hypoxemia) during or after eating, although this rarely coincided exactly with swallowing and was more common in patients who also experienced desaturation during the baseline recordings. Further studies are required to establish whether these changes are clinically important.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Rowat, Dr Anne
• Authors: Rowat, A. M., Wardlaw, J. M., Dennis, M. S., and Warlow, C. P.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Nursing and Health Care
• Journal Name: Stroke
• Publisher: American Heart Association
• ISSN: 0039-2499
• ISSN (Online): 1524-4628