MedicalResearch.com Interview with:
Craig Anderson | MD PhD FRACP
Professor of Neurology and Epidemiology, Faculty of Medicine, UNSW Sydney
Neurologist, Neurology Department, Royal Prince Alfred Hospital
The George Institute for Global Health at Peking University Health Science Center
Haidian District | Beijing, 100088 P.R. China
MedicalResearch.com: What is the background for this study? What are the main findings?
Preliminary small studies indicate that lying flat increases blood flow and oxygenation to the brain. Thus, patients with acute ischemic stroke may benefit from lying flat in bed. Conversely, sitting up in bed, with the head elevated to at least 30 degrees, may reduce swelling in the brain for patients who have large ischemic or hemorrhagic forms of stroke. The optimal head position to produce the best outcome from acute stroke, and avoid potential risks, such as aspiration pneumonia, is unknown. We undertook a large scale multicentre randomized controlled trial where 114 hospitals were randomised to sequentially apply lying flat or sitting up head positioning as a policy of care to a consecutive series of patients, that overall totalled over 11000 patients, presenting with acute stroke
. The study showed there was no difference in the chance of good physical recovery for patients between the two head positions but also that there were no excessive harms for either.
In other words, head positioning alone didn’t produce any benefits or harms in patients with acute stroke