1. Home>
2. Specialties>
3. General Medicine>
4. Summary and Comment

HEMODILUTION DOES NOT IMPROVE OUTCOME IN STROKE.

Moderate hemodilution has been suggested as a possible treatment for acute stroke because it is believed to increase cerebral blood flow by lowering the hematocrit. To determine whether hemodilution can improve outcome after a stroke, investigators conducted a controlled prospective trial in 1267 stroke patients. Patients were randomized to undergo hemodilution (by bloodletting and administration of dextran) or control treatment within 12 hours after the onset of symptoms.

In the hemodilution group, the hematocrit was reduced 13 percent (from a mean of 42.7 to 37.2) and was maintained for at least one week. At the time of discharge and six months later, there were no significant differences in the severity of impairment or the death rate between the two groups, and no differences between patients with ischemic stroke and those with hemorrhagic stroke. A subgroup of patients who underwent hemodilution within six hours of the onset of symptoms had no benefits from early treatment. Eighteen patients had side effects that may have been due to hemodilution.

The authors conclude that moderate hemodilution does not improve the short- or long-term outcome in patients with stroke.

— HGA

Published in Journal Watch General Medicine March 8, 1988

Citation(s):

Italian Acute Stroke Study Group. Haemodilution in acute stroke: results of the Italian haemodilution trial. Lancet 1988 Feb 13 1 318-321.

• Medline abstract (Free)