Haemodilution in acute ischaemic stroke comparison of two haemodilution regimen.
In a prospective study we randomly allocated 50 patients with acute ischaemic stroke in the area of the middle cerebral artery within 12 hours after onset to two moderate hypervolemic haemodilution regimen consisting of 500 ml of 10% hydroxyethyl starch per day for 10 days. In the high haematocrit group the target haematocrit of 41-42% was achieved by 0-3 phlebotomies and additional replacement of that volume with the colloid in 3 days. In the low haematocrit group with 1-4 phlebotomies a target haematocrit of 37-38% was reached in 4 days. The groups did not differ regarding age, risk factors, haematocrit and neurological score. The improvement of the disturbed blood rheology was more pronounced in the low haematocrit group. One death occurred in each group. The neurological score showed a significantly greater increase in the low haematocrit group with +59% at day 5 and +125% at day 11; the data for the high haematocrit group were +34% and +89% respectively. We calculated a correlation (r = 0.36, p less than 0.02) between the rise in neurological score and the reduction of haematocrit. Our data suggest but not do prove that an early start on moderate hypervolemic haemodilution is beneficial in patients with acute ischaemic stroke and disturbed blood rheology.
Klinikum Mannheim, Universität Heidelberg, Germany.
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U
Staedt
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E
Holm
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H
Leweling
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DL
Heene
D000368:Aged; D001792:Blood Platelets / Q000502:physiology; D001794:Blood Pressure; D001809:Blood Viscosity; D002545:Brain Ischemia / Q000097:blood* / Q000503:physiopathology / Q000628:therapy*; D002544:Cerebral Infarction / Q000097:blood* / Q000503:physiopathology / Q000628:therapy*; D004912:Erythrocytes / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006400:Hematocrit; D006438:Hemodilution / Q000379:methods*; D006801:Humans; D008297:Male