Acute Ischemic Stroke: General Supportive Care and Physiologic Monitoring

Acute ischemic stroke (AIS) requires prompt, coordinated supportive care from the earliest hours of presentation. This protocol defines key early interventions and physiologic monitoring targets that apply across the acute inpatient phase of AIS management.

Clinical Situation

Patients presenting with acute ischemic stroke in the inpatient setting require structured attention to oxygenation status, temperature, and glycemic levels alongside early antiplatelet and DVT prevention measures. Each of these domains independently influences functional recovery and survival outcomes.

Approach Overview

General supportive care includes early antiplatelet therapy initiated within a specific time window after stroke onset, supplemental oxygen for patients with reduced oxygen saturation, and active management of body temperature in the setting of fever. Glycemic abnormalities — both low and persistently elevated blood glucose — are addressed through defined interventions. Patients with impaired mobility receive targeted DVT prevention. The complete sequence, monitoring parameters, and full clinical criteria are available in the structured protocol.

Key Treatment Targets

Oxygen saturation maintained above 94%
Blood glucose maintained at 140 to 180 mg/dL
Body temperature kept below 37.5°C (normothermia)

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1161/STR.0000000000000513

In patients with AIS, administration of aspirin is recommended within 48 hours after stroke onset to reduce risk of death and dependency.
In patients with AIS with hypoxia, supplemental oxygen should be provided to maintain oxygen saturation (SpO2) >94%.
In patients with AIS who have hyperthermia, targeting normothermia, including using nurse-initiated protocols for managing fever, is recommended for improving functional outcomes and reducing death.
In patients with AIS, hypoglycemia (blood glucose <60 mg/dL) should be treated to avoid complications.
In patients with AIS, it is reasonable to treat persistent hyperglycemia to achieve blood glucose levels in a range of 140 to 180 mg/dL with close monitoring to prevent worse functional outcomes.
In patients with AIS who have impaired mobility and do not have contraindications to intermittent pneumatic compression (IPC), IPC in addition to routine care is recommended over routine care alone to reduce the risk of deep vein thrombosis (DVT).

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