The importance of targeted correction of volume status in the acute period in patients with ischemic stroke for the early start of physical rehabilitation

Objective. To evaluate the effectiveness of early targeted infusion therapy in patients with ischemic stroke, in combination with high-protein nutritional support calculated based on the level of urea in daily urine, in terms of reducing the time of onset of physical rehabilitation. Materials and methods. In two comparable groups of patients with ischemic stroke, hypovolemia was corrected: in the main group, in addition to basic infusion therapy, bolus administration with orientation according to the FloTrac® system and high-protein nutrition calculated based on the level of urea in daily urine were used; the control group received basic infusion therapy according to generally accepted approaches and nutrition without priority of high protein intake. The timing of the onset of motor rehabilitation from the moment of admission and the degree of neurological deficit according to the NIHSS scale at discharge from the hospital were assessed. Results. In the main group, rehabilitation sessions began, on average, one day earlier than in the control group; also, the main group had a lower NIHSS score at discharge. Conclusions. Targeted correction of hypovolemia with a focus on the indicator of the increase in stroke volume during the passive leg raise test (FloTrac®) allows for earlier initiation of active physical rehabilitation and improves long-term prognosis.