Adjusted hypervolemic hemodilution in acute ischemic stroke.
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Status:
Trial complete. Results published 1990.
Purpose:
To test the efficacy of adjusted hypervolemic hemodilution in reducing the neurologic deficit and disability in patients with acute ischemic stroke.
Interventions:
Dextran
Dextran is used as a volume expander.
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Hemodilution
Decreased viscosity may increase cerebral blood flow or oxygen delivery
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Location(s):
University Hospital of Zurich
Design:
Prospective, randomized, controlled trial of 47 patients at a single center.
Inclusion Criteria
Presumed acute ischemic stroke of the middle cerebral artery.
Exclusion Criteria
Transient ischemic attack, cerebral hemorrhage or tumor as shown by computed tomography, brain stem infarction, impaired level of consciousness at the time of admission, presenting >24 hours after initial onset, hypoglycemia or other metabolic disturbances possibly linked to neurologic deficits, overt heart failure or angina pectoris at rest, acute or subacute myocardial infarction, renal failure, dextran hypersensitivity, disabling disease, anticoagulation, or hematocrit <35%.
Patient Involvement:
Patients were randomized to either adjusted hypervolemic hemodilution or control. Rapid hemodilution to a target hematocrit of 30- 35% as monitored with bedside determinations was achieved by using infusions of dextran 40, venesections, and infusions of additional crystalloid solution when necessary for 3 days. Patients in control group received infusion of 0.9% saline.
Primary Outcome:
Relative improvement in neurologic function as determined using a modified Mathew score from day 1 to days 8, 21, and 90 and severe disability at days 8 and 21, light and stick tests of motor control, plasma viscosity, death.
Results:
There was no difference in the death rate or plasma viscosity between the two treatment groups. The relative improvement in neurologic function from day 1 to days 8, 21, and 90 was significantly better in the hemodilution group than in the control group. The frequency of patients with severe disability was significantly lower in the hemodilution group on days 8 and 21. The frequency of patients with an improvement in light and stick tests of motor control was significantly higher in the hemodilution group.
Source of Information:
Published report 1990.
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This information last updated on: 11/9/2000
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