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The Stroke Oxygen Study: a multi-centre, prospective, randomised, open, blinded-endpoint study of routine oxygen treatment in the first 72 hours after a stroke
Source of recordUK Clinical Trials Gateway
ISRCTNISRCTN52416964
Date ISRCTN assigned10/07/2007
Local reference number(s)06/Q2604/109
Public titleThe Stroke Oxygen Study: a multi-centre, prospective, randomised, open, blinded-endpoint study of routine oxygen treatment in the first 72 hours after a stroke
Scientific title
AcronymSO2S
Disease/condition/study domainStroke, cerebral infarct, intracerebral haemorrhage, cerebrovascular disease
Study hypothesisMain Hypothesis:
Fixed dose oxygen treatment during the first three days after an acute stroke improves outcome.

Secondary hypothesis:
Restricting oxygen supplementation to night time only is more effective than continuous supplementation.

The pilot study of this trial can be found at ISRCTN12362720 (http://www.controlled-trials.com/ISRCTN12362720).
Design/methodologyA multi-centre, prospective, randomised, open, blinded-endpoint study.
Research ethics reviewReceived from the Local Research Ethics Committee (Mellor House, Corporation Sreet, Stafford, ST16 3SR, UK) on the 31st October 2006 (ref: 06/Q260/109), protocol version 2 approved on 24th January 2007.
Countries of trialUnited Kingdom (multiple centres [30 - 40] in the UK and worldwide)
Participants - inclusion criteriaAdult patients are eligible for trial inclusion if they were admitted with symptoms of an acute stroke within the preceding 24 hours, and if, in the doctor¿s opinion, there is no clear indication for and no clear contraindication against oxygen treatment:
1. Potential indications for oxygen treatment could be:
1.1. Oxygen saturation on air less than 90%
1.2. Hypoxia associated with acute left ventricular failure
1.3. Severe pneumonia
1.4. Pulmonary embolus
1.5. Chronic respiratory failure patients treated with long term oxygen at home
2. Potential contraindications to fixed dose oxygen treatment could be:
2.1. Type 2 respiratory failure
2.2. Very severe hypoxia
3. Medical centres are eligible for participation in the study if they admit patients with acute stroke, are able to provide oxygen treatment and monitor oxygen saturation, and if there is a local researcher who will act as the principal investigator for the locality
Participants - exclusion criteriaPatients will be excluded from the trial if:
1. The responsible doctor considers the patient to have definite indications for or contraindications to oxygen treatment at a rate of 2 - 3 L/min. The decision will be left to the responsible clinician
2. The stroke is not the main clinical problem
3. He/she has another serious life-threatening illness likely to lead to death within the next few months. This group of patients is excluded because it is unlikely that they are going to derive any benefit from the trial treatment
Patient information material
Anticipated start date01/11/2007
Anticipated end date01/11/2013
Status of trialOngoing
Target number of participants6000
InterventionsTreatment group 1: no routine oxygen supplementation during the first 72 hours after randomisation.

Treatment group 2: oxygen per nasal cannula overnight (21:00 - 7:00) at a flow rate of 3 L/min (if baseline oxygen saturation is 93% or below) or at a flow rate of 2 L/min (if baseline oxygen saturation is greater than 93%) during the first three nights after randomisation.

Treatment group 3: oxygen per nasal cannula continuously (day and night) at a flow rate of 3 L/min (if baseline oxygen saturation is 93% or below) or a flow rate of 2 L/min (if baseline oxygen saturation is greater than 93%) during the first 72 hours after randomisation.

All patients will have regular observations of vital signs (blood pressure, heart rate, temperature and oxygen saturation) as per the local protocol of the stroke unit, but at least six-hourly. Treatment of any abnormal findings will be independent of trial allocation. Patients who require oxygen or changes in the dose of oxygen for clinical reasons at any time of the trial will be given the concentration of oxygen they require.
Primary outcome measure(s)Modified Rankin Scale score at three months.
Secondary outcome measure(s)1. Secondary outcomes at one week:
1.1. Mortality
1.2. Number of patients with neurological deterioration (death or a greater than 4 point increase in the National Institutes of Health Stroke Scale [NIHSS])
1.3. Deaths
1.4. Highest oxygen saturation during the first 72 hours
1.5. Lowest oxygen saturation during the first 72 hours

2. Secondary outcomes at three months:
2.1. Mortality
2.2. Percentage of patients living at home
2.3. Ability to perform activities of daily living (Barthel index)
2.4. Quality of life (EuroQuol)
2.5. Extended Activities of Daily Living (Nottingham EADL score)
Trial websitehttp://www.so2s.co.uk
PublicationsResults of a pilot trial carried out in preparation of the SO2S study protocol: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16159091

Results of a survey carried out in preparation for the SO2S study protocol: http://www.bjcardio.co.uk/download/2287
Sources of funding1. North Staffordshire Combined Healthcare NHS Trust (UK)
2. Keele University (UK)
3. Research for Patient Benefit (RfPB), National Institute for Health Research (UK) - outcome of application pending
Sponsor nameNorth Staffordshire Combined Healthcare NHS Trust (UK)
Sponsor detailsc/o Mr Darren Clement
Research and Development Consortium
University Hospital of North Staffordshire
Newcastle Road
Staffordshire
Stoke-on-Trent
United Kingdom
ST4 6QG
Sponsor telephone+44 (0)1782 554839
Sponsor fax+44 (0)1782 41 22 36
Sponsor emaild.j.clement@uhns.nhs.uk
Sponsor websitehttp://www.nsch-tr.wmids.nhs.uk/site/show_page.php3?page_id=1
Contact nameDr Christine Roffe
Contact detailsSpringfield Unit
University Hospital of North Staffordshire
Newcastle Road
Staffordshire
Stoke-on-Trent
United Kingdom
ST4 6QG
Contact telephone+44 (0)1782 553369
Contact fax+44 (0)1782 552138
Contact emailChristine.roffe@northstaffs.nhs.uk
More informationFor more up-to-date information please go to the ISRCTN link below.
Link to record in ISRCTN RegisterISRCTN52416964
Date last extracted from ISRCTN register17/04/2008
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