{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T04:14:02Z","timestamp":1789532042871,"version":"build-2803163510"},"reference-count":22,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T00:00:00Z","timestamp":1692316800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010661","name":"Horizon 2020 Framework Programme","doi-asserted-by":"publisher","award":["SC1-PM-09-2016"],"award-info":[{"award-number":["SC1-PM-09-2016"]}],"id":[{"id":"10.13039\/100010661","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Stroke"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                    <jats:title>Rationale:<\/jats:title>\n                    <jats:p>Oxygen is essential for cellular energy metabolism. Neurons are particularly vulnerable to hypoxia. Increasing oxygen supply shortly after stroke onset could preserve the ischemic penumbra until revascularization occurs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims:<\/jats:title>\n                    <jats:p>PROOF investigates the use of normobaric oxygen (NBO) therapy within 6\u2009h of symptom onset\/notice for brain-protective bridging until endovascular revascularization of acute intracranial anterior-circulation occlusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and design:<\/jats:title>\n                    <jats:p>Randomized (1:1), standard treatment-controlled, open-label, blinded endpoint, multicenter adaptive phase IIb trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study outcomes:<\/jats:title>\n                    <jats:p>Primary outcome is ischemic core growth (mL) from baseline to 24\u2009h (intention-to-treat analysis). Secondary efficacy outcomes include change in NIHSS from baseline to 24\u2009h, mRS at 90\u2009days, cognitive and emotional function, and quality of life. Safety outcomes include mortality, intracranial hemorrhage, and respiratory failure. Exploratory analyses of imaging and blood biomarkers will be conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Sample size:<\/jats:title>\n                    <jats:p>Using an adaptive design with interim analysis at 80 patients per arm, up to 456 participants (228 per arm) would be needed for 80% power (one-sided alpha 0.05) to detect a mean reduction of ischemic core growth by 6.68\u2009mL, assuming 21.4\u2009mL standard deviation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>By enrolling endovascular thrombectomy candidates in an early time window, the trial replicates insights from preclinical studies in which NBO showed beneficial effects, namely early initiation of near 100% inspired oxygen during short temporary ischemia. Primary outcome assessment at 24\u2009h on follow-up imaging reduces variability due to withdrawal of care and early clinical confounders such as delayed extubation and aspiration pneumonia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registrations:<\/jats:title>\n                    <jats:p>ClinicalTrials.gov: NCT03500939; EudraCT: 2017-001355-31.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17474930231185275","type":"journal-article","created":{"date-parts":[[2023,7,29]],"date-time":"2023-07-29T05:03:44Z","timestamp":1690607024000},"page":"120-126","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["Penumbral Rescue by normobaric O\u2009=\u2009O administration in patients with ischemic stroke and target mismatch proFile (PROOF): Study protocol of a phase IIb trial"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0286-8781","authenticated-orcid":false,"given":"Sven","family":"Poli","sequence":"first","affiliation":[{"name":"Department of Neurology & Stroke, Eberhard-Karls University, University Hospital, Tubingen, Germany"},{"name":"Hertie Institute for Clinical Brain Research, Eberhard-Karls University, Tubingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Mbroh","sequence":"additional","affiliation":[{"name":"Department of Neurology & Stroke, Eberhard-Karls University, University Hospital, Tubingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Claude","family":"Baron","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hopital Sainte-Anne, Universite de Paris, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aneesh 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