Stroke: The efficacy of active oxygen scavengers in patients with acute cerebral hemorrhage

Patients with cerebral hemorrhage are accompanied by increased oxidative stress.
Oxidative stress contributes to the occurrence and development of peripheral hematomas in patients with cerebral hemorrhage.

Recently, the medsci.
cn/course/search.
do?w=%E5%BF%83%E8%A1%80%E7%AE%A1">heart blood vessels published a research article on the disease areas authoritative journal Stroke, researchers speculate that reactive oxygen species (ROS) scavenger may play a neuroprotective effect in acute cerebral hemorrhage.

This prospective, multicenter, single-blind, randomized study was conducted from June 2017 to October 2019.
Intracranial hemorrhage includes secondary cerebral hemorrhage caused by spontaneous cerebral hemorrhage, abnormal blood vessels, venous thrombosis , tumor or hemorrhagic infarction.
The active oxygen scavenger n-acetylcysteine ​​2000mg/d and selenium 1600μg/d were given intravenously for 14 days.
Other patients received placebo treatment.
The main outcome of the study was the changes in the volume of bleeding and perihematomal edema (PHE) in the ROS scavenger group and the placebo group during the 2-week follow-up.

A total of 448 patients were included in the study, and there were still 123 patients after screening through the inclusion and exclusion criteria .
There were no significant differences in the baseline characteristics of patients between the ROS scavenger group (n=57) and the placebo group (n=66).
There was no significant difference between baseline hematoma and PHE volume, but the computed tomography risk PHE volume (21.
90±17.
63 vs 30.
66±32.
35, P＜0.
01) and PHE ratio (1.
19±0.
73 vs 2.
05±1.
27, P＜0.
01) at the 2-week follow-up were Significant differences.
Among many clinical factors, compared with the control group, the time for patients treated with ROS scavengers to reach the target value of the RASS sedation assessment table (5.
98 hours (95% CI 4.
82-7.
241 and 8.
42 hours (95% CI 6.
57- 10.
77), P＜0.
01) and the length of stay in the intensive care unit (6.
46 days (95%CI: 2.
38-10.
55 and 12.
66 days (95%CI: 8.
47-16.
85), P＜0.
01).

It can be seen that the ROS scavenger significantly reduces the volume of PHE in patients with acute cerebral hemorrhage, and shortens the time to reach the target value of the RASS sedation assessment table and the hospital stay in the intensive care unit .
In this study, early and high-dose ROS scavengers may have played a key role in achieving good outcomes.

Original source:

Moinay Kim.
et al.
Reactive Oxygen Species Scavenger in Acute Intracerebral Hemorrhage Patients
A Multicenter, Randomized Controlled Trial .