Stroke, Vol 18, 691-699, Copyright © 1987 by American Heart Association
Hemodilution by the combination of venesection and dextran 40
administration has previously been reported to enhance neurologic recovery
in the acute phase of ischemic stroke. To study this therapeutic principle
in its "natural habitat," a stratified and randomized multicenter trial
involving 15 large and small hospitals was performed. Patients with acute
ischemic stroke of less than 48 hours' duration and with hematocrits of
38-50% on admission were randomized to a hemodilution (183 patients, mean
age 72.0 years) or a control group (190 patients, mean age 71.6 years). The
two groups did not differ in sex distribution or medical history.
Hematocrit, blood pressure, and neurologic score were closely similar at
entry. By graded venesection (250-1000 ml) during the first 2 days and
dextran 40 infusions (500 ml daily) during 5 days, the mean hematocrit was
reduced from 44.2 to 37.1%. Three-month survival expressed as life table
product was 0.84 in hemodilution and 0.88 in control patients. In
survivors, neurologic score and activities of daily living performance
during 3 months of follow-up were not improved by hemodilution. Length of
stay in an acute- care hospital and the need for long-term institutional
care was not reduced among patients in the hemodilution group. Major
cardiovascular events occurred somewhat more often and there was an
apparent increase in mortality during the first few days of hemodilution
therapy. However, the differences were not significant. We conclude that
the present standardized treatment with moderate hemodilution has no
overall beneficial effects in general patients with acute ischemic stroke.
ARTICLES
Multicenter trial of hemodilution in acute ischemic stroke. I. Results in the total patient population. Scandinavian 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]
|
|
|
|
 |
|
 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]
|
|
|
|
|
|
C. S. Weaver, J. Leonardi-Bee, F. J. Bath-Hextall, and P. M.W. Bath Sample Size Calculations in Acute Stroke Trials: A Systematic Review of Their Reporting, Characteristics, and Relationship With Outcome Stroke, May 1, 2004; 35(5): 1216 - 1224. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Sivenius, T. Sarasoja, H. Aaltonen, E. Heinonen, O. Kilkku, and K. Reinikainen Selegiline Treatment Facilitates Recovery After Stroke Neurorehabil Neural Repair, September 1, 2001; 15(3): 183 - 190. [Abstract] [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]
|
|
|
|
|
|
N. G. Wahlgren, E. Diez-Tejedor, J. Teitelbaum, A. Arboix, D. Leys, T. Ashwood, and E. Grossman Results in 95 Hemorrhagic Stroke Patients Included in CLASS, a Controlled Trial of Clomethiazole Versus Placebo in Acute Stroke Patients Stroke, January 1, 2000; 31(1): 82 - 85. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Tomiyama, J. E. Brian Jr, M. M. Todd, and W. Pearce Cerebral Blood Flow During Hemodilution and Hypoxia in Rats : Role of ATP-Sensitive Potassium Channels • Editorial Comment: Role of ATP-Sensitive Potassium Channels Stroke, September 1, 1999; 30(9): 1942 - 1948. [Abstract] [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]
|
|
|
|
|
|
N.G. Wahlgren, K.W. Ranasinha, T. Rosolacci, C.L. Franke, P.M.M. van Erven, T. Ashwood, and L. Claesson Clomethiazole Acute Stroke Study (CLASS) : Results of a Randomized, Controlled Trial of Clomethiazole Versus Placebo in 1360 Acute Stroke Patients Stroke, January 1, 1999; 30(1): 21 - 28. [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]
|
|
|
|
|
|
S. Schwarz, S. Schwab, M. Bertram, A. Aschoff, and W. Hacke Effects of Hypertonic Saline Hydroxyethyl Starch Solution and Mannitol in Patients With Increased Intracranial Pressure After Stroke Stroke, August 1, 1998; 29(8): 1550 - 1555. [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]
|
|
|
|
|
|
K. Yanaka, P. J. Camarata, S. R. Spellman, D. E. McDonald, and R. C. Heros Optimal Timing of Hemodilution for Brain Protection in a Canine Model of Focal Cerebral Ischemia Stroke, May 1, 1996; 27(5): 906 - 912. [Abstract] [Full Text]
|
|
|
|
|
|
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. L. Frey The Future of Acute Stroke Treatment: Lessons We Have Learned From Laboratory and Clinical Research Arch Intern Med, May 22, 1995; 155(10): 1005 - 1006. [Abstract] [PDF]
|
|
|
|
 |
|
 J. C Grotta Prevention and management of stroke Vascular Medicine, March 1, 1991; 2(1): 3 - 17. [PDF]
|
|
|
|
|
|
S. R. Levine Acute Cerebral Ischemia in a Critical Care Unit: A Review of Diagnosis and Management Arch Intern Med, January 1, 1989; 149(1): 90 - 98. [Abstract] [PDF]
|
|
|
|
 |
|
 L. R. Wechsler Analytic Reviews : Potential New Therapies for Acute Ischemic Stroke J Intensive Care Med, September 1, 1988; 3(5): 258 - 264. [Abstract] [PDF]
|
|