Hemodynamics of stroke patients under therapy with low molecular weight hydroxyethyl starch

In stroke penumbra perfusion depends passively on hemodynamics. So far hemodynamic effects of low molecular weight hydroxyethylstarch (HES) has not been investigated. Ten stroke patients received hypervolemic HES therapy. Cardiac output and heart rate were monitored using the bioimpedance method, blood pressure by conventional measurement. The Scandinavian Stroke Scale assessed clinical outcome. Circadian cardiac output changes were measured in 20 controls. Patients' cardiac output increased after the loading dose (5.3 +/- 1.4 l min(-1) to 6.5 +/- 1.7 l min(-1), p < 0.01), fluctuating then between 5 and 7 l min(-1) without nocturnal decrease. Beside an initial increase, the heart rate showed, like blood pressure, no remarkable changes. The Scandinavian Stroke Scale score did not change significantly. The controls showed a circadian cardiac output fluctuation (2.00 am, 5.3 +/- 0.3 l min(-1); 8.30 am, 8.1 +/- 0.6 l min(-1). Our patients showed a hemodynamic and clinical stabilization under therapy with low molecular weight HES. The physiological nocturnal decrease of cardiac output and blood, which might cause clinical deterioration in stroke patients, was avoided.