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ISC 2024 | ZODIAC trial results: conclusive evidence for head positioning in stroke care

Anne W Alexandrov, PhD, RN, CCRN, ANVP-BC, NVRN-BC, FAAN, University of Tennessee Health Science Center, Memphis, TN, presented the groundbreaking findings of the ZODIAC trial (NCT03728738) at the recent ISC 2024 conference, investigating the use of 0-degree head of bed (HOB) positioning prior to thrombectomy in patients with large vessel occlusion (LVO) ischemic stroke. The trial included 92 patients and aimed to determine whether a 0-degree HOB position compared to an elevated 30-degree HOB position results in greater clinical stability during the critical pre-thrombectomy period. The researchers used the National Institutes of Health Stroke Scale (NIHSS) to assess neurological function, finding that patients with a 0-degree HOB position had fewer neurological deficits compared to those with a 30-degree HOB incline at both 24 hours and 7 days after discharge. Notably, 1 in 2 patients enrolled in the 30-degree group had worsened neurological function during the pre-thrombectomy period, however, the patients in the 0-degree group remained very stable and/or improved. Prof. Alexandrov highlights significant benefits from this simple and cost-free intervention and anticipates guideline changes in LVO patient care. This interview took place during the International Stroke Conference 2024 in Phoenix, AZ.

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