Effect of hypervolaemic haemodilution of regional cerebral blood flow in patients with acute ischaemic stroke: a controlled study with hydroxyethylstarch

Abstract

A controlled study of the effect of hypervolaemic haemodilution on cerebral blood flow (CBF) was performed using 10% hydroxyethylstarch (HES) in 27 patients with acute cerebral ischaemia. Of the patients, 12 were randomly allocated as controls without HES infusion and 15 received 500 ml HES daily, infused over a period of 5-7 h, for 7 days. CBF was measured on days 1, 2 and 7 by the xenon 133 inhalation method and calculated as initial slope index. In the HES-treated group, CBF increased in both hemispheres (P less than 0.001) from day 1 to day 2 and, in addition, in the infarcted hemispheres from day 2 to day 7 (P less than 0.01). In the control group, the hemispheric flow of the involved side had decreased (P less than 0.001) by day 2 and had not significantly changed by day 7; however, in the contralateral hemisphere flow did not change. In hypaemic regions the increase in flow was larger than in other regions in both groups. Regional flow had increased more in the HES-treated group than in controls at both day 2 (P less than 0.01) and day 7 (P less than 0.002). Hypervolaemic haemodilution with HES was able to improve hemispheric and regional flow significantly, particularly in infarcted hemispheres and hypaemic regions with acute cerebral ischaemia.