Stroke, Vol 20, 317-323, Copyright © 1989 by American Heart Association
Patients with acute ischemic stroke were randomized less than 24 hours
after onset to standard (S) therapy (n = 43) or to hypervolemic
hemodilution (HH) with pentastarch (n = 45). The therapeutic goal of
hypervolemic hemodilution was to rapidly reduce hematocrit to 33%, to raise
cardiac output, and to continue hypervolemic hemodilution for 3 days. A
graded neurologic examination was scored by a blinded observer at
randomization (baseline), at the end of treatment or after 72 hours, and at
a 3-month follow-up; each patient was also rated using Barthel's disability
scale at the 3-month follow-up. Group demographics and results of the
graded neurologic examination were similar at baseline, except that the HH
group contained twice the number of patients with severe strokes and fewer
patients randomized within 12 hours compared with the S group. The HH group
improved an average of 7 points in neurologic score from baseline to the
end of treatment (the S group deteriorated 1 point) and 24 points by the
3-month follow-up (the S group improved 16 points; p = 0.11). The HH group
reached an average Barthel disability scale index of 85 while the S group
averaged 70 (p = 0.8). Deaths associated with cerebral edema occurred in
five patients with severe stroke (four in the HH group vs. one in the S
group, p = 0.36). The following subgroups of HH patients showed better
overall improvement in neurologic scores: patients entered within 12 hours
after stroke onset, patients with a 15% decrease in hematocrit, and
patients with a 10% increase in cardiac output.(ABSTRACT TRUNCATED AT 250
WORDS)
ARTICLES
Hypervolemic hemodilution treatment of acute stroke. Results of a randomized multicenter trial using pentastarch. The Hemodilution in Stroke Study Group
This article has been cited by other articles:
 |
|
 |
|
  H. P. Adams Jr, G. del Zoppo, M. J. Alberts, D. L. Bhatt, L. Brass, A. Furlan, R. L. Grubb, R. T. Higashida, E. C. Jauch, C. Kidwell, et al. Guidelines for the Early Management of Adults With Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: The American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists. Circulation, May 22, 2007; 115(20): e478 - e534. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. P. Adams Jr, G. del Zoppo, M. J. Alberts, D. L. Bhatt, L. Brass, A. Furlan, R. L. Grubb, R. T. Higashida, E. C. Jauch, C. Kidwell, et al. Guidelines for the Early Management of Adults With Ischemic Stroke: A Guideline From the American Heart Association/ American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: The American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists Stroke, May 1, 2007; 38(5): 1655 - 1711. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. G. Stead, R. M. Gilmore, W. W. Decker, A. L. Weaver, and R. D. Brown Jr Initial emergency department blood pressure as predictor of survival after acute ischemic stroke Neurology, October 25, 2005; 65(8): 1179 - 1183. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Evidence-based Colloid Use in the Critically Ill: American Thoracic Society Consensus Statement Am. J. Respir. Crit. Care Med., December 1, 2004; 170(11): 1247 - 1259. [Full Text] [PDF]
|
|
|
|
 |
|
 G. R. Haynes, T. A. Neff, R. Stocker, and D. R. Spahn Is Hydroxyethyl Starch Safe in Brain Injury? * Response Anesth. Analg., August 1, 2004; 99(2): 620 - 622. [Full Text] [PDF]
|
|
|
|
 |
|
 M. E. Barron, M. M. Wilkes, and R. J. Navickis A Systematic Review of the Comparative Safety of Colloids Arch Surg, May 1, 2004; 139(5): 552 - 563. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. P. Adams Jr, R. J. Adams, T. Brott, G. J. del Zoppo, A. Furlan, L. B. Goldstein, R. L. Grubb, R. Higashida, C. Kidwell, T. G. Kwiatkowski, et al. Guidelines for the Early Management of Patients With Ischemic Stroke: A Scientific Statement From the Stroke Council of the American Stroke Association Stroke, April 1, 2003; 34(4): 1056 - 1083. [Full Text] [PDF]
|
|
|
|
|
|
R. A. Felberg, N. J. Okon, A. El-Mitwalli, W. S. Burgin, J. C. Grotta, and A. V. Alexandrov Early Dramatic Recovery During Intravenous Tissue Plasminogen Activator Infusion: Clinical Pattern and Outcome in Acute Middle Cerebral Artery Stroke Stroke, May 1, 2002; 33(5): 1301 - 1307. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Uchino, D. Billheimer, and S. C. Cramer Entry Criteria and Baseline Characteristics Predict Outcome in Acute Stroke Trials Stroke, April 1, 2001; 32(4): 909 - 916. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Belayev, Y. Liu, W. Zhao, R. Busto, and M. D. Ginsberg Human Albumin Therapy of Acute Ischemic Stroke : Marked Neuroprotective Efficacy at Moderate Doses and With a Broad Therapeutic Window Stroke, February 1, 2001; 32(2): 553 - 560. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. S. Kaplan, T. S. Park, E. R. Gonzales, J. M. Gidday, and J. A. Zivin Hydroxyethyl Starch Reduces Leukocyte Adherence and Vascular Injury in the Newborn Pig Cerebral Circulation After Asphyxia Editorial Comment Stroke, September 1, 2000; 31(9): 2218 - 2223. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Davis and D. Barer Neuroprotection in acute ischaemic stroke. II: Clinical potential Vascular Medicine, August 1, 1999; 4(3): 149 - 163. [Abstract] [PDF]
|
|
|
|
|
|
J. C. Grotta Acute Stroke Therapy at the Millennium: Consummating the Marriage Between the Laboratory and Bedside : The Feinberg Lecture Stroke, August 1, 1999; 30(8): 1722 - 1728. [Full Text] [PDF]
|
|
|
|
|
|
J. Berrouschot, H. Barthel, J. Koster, S. Hesse, A. Rossler, W. H. Knapp, and D. Schneider Extracorporeal Rheopheresis in the Treatment of Acute Ischemic Stroke : A Randomized Pilot Study Stroke, April 1, 1999; 30(4): 787 - 792. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Berrouschot, H. Barthel, R. von Kummer, W. H. Knapp, S. Hesse, and D. Schneider 99mTechnetium-Ethyl-Cysteinate-Dimer Single-Photon Emission CT Can Predict Fatal Ischemic Brain Edema Stroke, December 1, 1998; 29(12): 2556 - 2562. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Belayev, W. Zhao, P. M. Pattany, R. G. Weaver, P. W. Huh, B. Lin, R. Busto, M. D. Ginsberg, S. Mori, and R. J. Traystman Diffusion-Weighted Magnetic Resonance Imaging Confirms Marked Neuroprotective Efficacy of Albumin Therapy in Focal Cerebral Ischemia • Editorial Comment Stroke, December 1, 1998; 29(12): 2587 - 2599. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. T. Aichner, F. Fazekas, M. Brainin, W. Polz, B. Mamoli, and K. Zeiler Hypervolemic Hemodilution in Acute Ischemic Stroke : The Multicenter Austrian Hemodilution Stroke Trial (MAHST) Stroke, April 1, 1998; 29(4): 743 - 749. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y.-K. Tu and H.-M. Liu Effects of Isovolemic Hemodilution on Hemodynamics, Cerebral Perfusion, and Cerebral Vascular Reactivity Stroke, March 1, 1996; 27(3): 441 - 445. [Abstract] [Full Text]
|
|
|
|
|
|
J. C Grotta Prevention and management of stroke Vascular Medicine, March 1, 1991; 2(1): 3 - 17. [PDF]
|
|
|
|
 |
|
 A. Rebel, J. A. Ulatowski, K. Joung, E. Bucci, R. J. Traystman, and R. C. Koehler Regional cerebral blood flow in cats with cross-linked hemoglobin transfusion during focal cerebral ischemia Am J Physiol Heart Circ Physiol, March 1, 2002; 282(3): H832 - H841. [Abstract] [Full Text] [PDF]
|
|