[Continuous hemodilution using a low-molecular hydroxyethyl starch solution. Pilot studies in patients with acute...

The intention of this study was to examine whether it is possible to induce an acute and long-time hemodilution by a 6% Hydroxyethyl Starch solution (HES 40). This study was investigated in 30 patients with acute cerebral ischemia. Primarily a isovolemic infusion of HES 40 was made in order to reduce the hematocrit nearly 40%. Secondly, a hypervolemic infusion of 1,000 ml/24 h followed during 4 days. Then 500 ml/24 h for the next 6 days, respectively. The neurological staging was estimated by special scores, the rheological effects by changing of values of hematocrit, hemoglobin, plasma viscosity, number of blood cells, concentration of total plasma protein and fibrinogen concentration. It can be stated that HES 40 induced a significant acute and long time decrease of blood parameters (4 weeks later). After this time, the symptoms of cerebral ischemia could not be observed in 54% of cases and were reduced significantly in 31 percent. 2 patients had transitory ischemic attacks and 4 patients died during therapy. These results demonstrate that this new therapy (long time hemodilution with HES 40) is ingenious for patients with acute cerebral ischemia, because HES 40 has lower undesired effects than HES 200.