Summary. The keyproblem of hemorrhagic shock consists in decreased tissue nutrition and tissue drainage from metabolites with subsequent hypoxic cellular damage. In two groups of 50 dogs the effect of whole blood (n = 30) versus hemodilution with dextran-60 (n ~ 20) was evaluated from central hemodynamics, capillary blood flow and transcapillary exchange from tissue to blood in skeletal muscle by use of a double isotope technique. Following a period of hemorrhagic hypotension either all the shed blood or dextran-60 were infused. Hemodilution with dextran produced a decrease in hematocrit to 20°/o, lowered effeciently blood viscosity and TPR and increased cardiac output to 160°/o of control. Capillary blood flow and exchange were nearly doubled as compared to the control level. Retransfusion of blood caused only transient normalization with rapid deterioration in central and peripheral hemodynamics, together with an increase in blood viscosity. The viscosity depressant effect of hemodilution is discussed as key factor causing the better immediate response to dextran infusion in hemorrhagic shock.Key words: Hemorrhagic shock --Hemodilution --Hemorheology --Microcirculation.The effectiveness of colloids versus whole blood in prolonged hemorrhagic hypotension has been evaluated in numerous studies from changes in central hemodynamics, such as blood pressure, blood volume a n d cardiac o u t p u t ([8, 15], details see [26]). However, more recent investigations using new techniques [2,6,20,23,35,62] have focussed on the changes in the microvasculature, as the key point in the disturbance of tissue n u t r i t i o n and drainage in shock. F r o m the vascular changes three aspects have been stressed in particular, the decrease in driving pressure [20,62], the i m p a i r m e n t of capillary perfusion [3, 4, 10] a n d the impedance of transcapillary exchange processes [2,4,23] ; in addition it has * Dedicated to Prof. Dr. Dr. R. Zenker on his 70th anniversery.Symbols. AVDO 2 : arteriovenous oxygen difference (percent saturation), CO --cardiac output, HCT : large vessel hematocrit, MAP = mean arterial pressure, c.v.PO 2 ~ oxygen partial pressure in centralvenous blood, PSp = permeability-surface area product, TPR ~ total peripheral resistance.