title: The evolving role of hemodilution in treatment of cerebral vasospasm: a historical perspective.
abstract: OBJECTIVE
  Hypertension, hypervolemia, and hemodilution [HHH] therapy is widely used for prophylactic and therapeutic means in the setting of angiographic or clinical cerebral vasospasm. Hemodilution remains the most controversial aspect of the HHH therapy.
  
  
  METHODS
  We performed a literature review to identify the current state of support for hemodilution as a therapeutic modality in treatment of cerebral vasospasm.
  
  
  RESULTS
  Over time, evidence has been accumulating against the efficacy of HHH therapy and hemodilution in particular. Although HHH therapy and consequently hemodilution has wide support, the evidence for its effectiveness remains equivocal.
  
  
  CONCLUSIONS
  At the time of this study, the burden of evidence appears to be tipped away from hemodilution as a therapeutic modality.
authors.affiliation: Department of Neurosurgery, Louisiana State University Health Sciences Center at Shreveport, Shreveport, Louisiana, USA.
authors.forename: Prashant
authors.initials: P
authors.lastname: Chittiboina
authors.forename: Steven
authors.initials: S
authors.lastname: Conrad
authors.forename: Paul
authors.initials: P
authors.lastname: McCarthy
authors.forename: Anil
authors.initials: A
authors.lastname: Nanda
authors.forename: Bharat
authors.initials: B
authors.lastname: Guthikonda
mesh_terms: D000818:Animals; D001810:Blood Volume / Q000502:physiology; D006438:Hemodilution / Q000266:history / Q000379:methods* / Q000639:trends; D049673:History, 20th Century; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D013345:Subarachnoid Hemorrhage / Q000503:physiopathology; D016896:Treatment Outcome; D020301:Vasospasm, Intracranial / Q000628:therapy*