Endotracheal ventilation with subsequent artificial pulmonary ventilation is, on one hand, a necessary and life-preserving invasive procedure within the framework of intensive stroke care but, on the other hand, it also indicates a severe clinical state of the patient. There is not a complete agreement on the indications, timing and selection of patients with ischemic stroke for artificial pulmonary ventilation. The authors attempt to contribute to resolution of these issues and present a retrospective study of ventilated patients with ischemic stroke hospitalized in a neurological ICU in the course of three years (2000 – 2003). The group consisted of 20 patients with mean age of 68 years with ischemic stroke in the carotid (8) or vertebrobasilar (12) circulation. Artificial pulmonary ventilation was initiated most frequently on the second day (mean 30 hours). A complete controlled ventilation was required in 14 patients; in six patients we left spontaneous ventilation with pressure support. Tracheostomy was subsequently performed in 18 cases. The 30-day mortality was 25 % and the overall one (after three months) 45 %. A favorable outcome (60 and more points on Barthel Index) was reached after three months by all the 11 surviving patients (55 %). Based on our experience, ventilatory care is most beneficial for younger patients with extensive ischemic stroke in the carotid circulation (embolus from cardiac source); it is also beneficial for patients with ischemic stroke in the vertebrobasilar circulation without marked consciousness impairment. In patients with severe consciousness impairment, artificial pulmonary ventilation does not lead to improvements of the clinical outcome of stroke (death or severe resulting deficit).

        Key words: ischemic stroke, intubation, artificial pulmonary ventilation, ventilatory regimes