Procedures
stroke, ischemic stroke
STROKE, ISCHEMIC STROKE
In the HDP group, patients were positioned to −20° Trendelenburg position from 8:00 a.m. to 10:00 p.m. within the first 24 h after randomization. During this period, the patients were continuously monitored by ECG and blood oxygen saturation, and asked to report any discomfort. If the patients could not tolerate this position, they were then adjusted slowly to a horizontal position for 10 to 30 min, and then returned to −20°. The repositioning could be repeated during HDP treatment. After 24 h, patients were placed in a −20° Trendelenburg position with 1 to 1.5 h duration three times a day, from 9:00–11:00, 15:00–17:00, and 20:00–22:00, respectively. The treatment procedure lasted for 10 to 14 days. During the treatments, the side-lying position with −20° Trendelenburg was allowed if there was a high risk of aspiration suspected by local providers. In the control group, patients were treated according to the AHA/ASA 2018 guidelines for the early management of ischemic stroke without any intervention of head position (supine or sitting position determined by local investigator).Neurological status, measured with the NIHSS, was assessed at baseline, 7 days, and 12 days after randomization. Demographic and clinical details were obtained at randomization. Follow-up data were collected at 7 days, 12 days (or at hospital discharge if earlier), and 90 days after randomization. Remote and on-site quality control monitoring and data verification were performed throughout the study. All patients received standard medical management according to national stroke guidelines