[Acute isovolemic hemodilution during intracranial interventions with normo- and hypothermia]

In 50 neurosurgical patients (39 cerebral tumours and 11 aneurysms) isovloaemic haemodilution (HD) was carried out immediately before the operation. Of these, 37 were subsequently operated on with pharmacological-physical decrease in metabolism (30 to 32 degrees C) partly with arterial hypotension while 13 patients were operated on in normothermia without hypotension. A control group was formed of 50 patients with cerebral tumours who were operated on without HD in normothermia. 76 per cent of the operations could be carried out without transfusion of foreign blood. The mean values of the amounts of foreign blood were 120.0 ml in the HD-group as against 1344.0 ml in the control group. In the HD-group, dehydration measures could be completely renounced. Complications did not occur. Isovolaemic haemodilution, especially combined with pharmacological decrease in metabolism and controlled hypotension, can be recommended for all intracranial interventions involving greater risks.