[Basic intensive care of ischemic cerebral stroke. Method of therapeutic hemodilution]

Ischemic cerebral stroke (ICS) ranks among the most frequent causes of disability. The incidence of untoward consequences of ICS can be decreased by early adequate use of intensive care methods restoring tissue oxygenation in the focus. The most important methods of intensive care of ICS are measures notably improving microcirculation and essentially decreasing subsequent incidence of disabling complications. The basic component of intensive care ensuring favorable results is therapeutic hemodilution making use of modern plasma substitutes--second-generation hydroxyethyl starch Infukoll HES 6 and 10% solutions. Currently used methods including use of dextran-based solutions cannot normalize microcirculation in ICS patients, particularly if used in long course. Prolonged infusions of dextran-based solutions inevitably increases plasma viscosity and impairs the hemostasis system. An essential increase of plasma viscosity involves the need in a complex of appropriate drug therapy aimed at compensation for untoward aftereffects of high dextran doses. Therapeutic doses of dextran-based solutions do not notably improve blood rheology. By contrast, therapeutic hemodilution with Infukoll HES notably improves the results of intensive care of ICS.