[Current status of hemodilution therapy]

The concept of hemodilution bases on the presumed relation between impaired blood flow properties and the development and time course of ischaemic brain lesions. Animal experiments support this concept. However, recent clinical studies are disappointing. In animal experiments, treatment is initiated very early, almost undelayed (within 60 minutes), the experimental conditions are optimal and the animals are healthy. In contrast, there is a substantial delay between the onset of symptoms and the start of treatment in clinical routine conditions; furthermore, the cardiac reserve of elderly patients is limited. Therefore, the crucial question is: how can we create optimal treatment conditions to maximize the efficacy of hemodilution.