Effect of Hemodilution on Regional Cerebral Blood Flow in Patients with Acute Cerebral Infarction

Haemodilution for acute ischaemic stroke

“…In the analyses, they were divided into hyper- and isovolaemic. In 12 of the trials, the administration of a plasma volume expander was not combined with venesection and was, therefore, defined as hypervolaemic (ALIAS-Part 1 2011; ALIAS-Part 2 2013; Bornstein 1981; Frei 1987; Gilroy 1969; Haass 1989; Hartmann 1987; Kaste 1976; MAHST 1998; Matthews 1976; Rudolf 2002; Spudis 1973). In one study, venesection was performed only if there were signs of volume overload; this trial was also considered as hypervolaemic (HSSG 1989).…”

“…We considered these 13 RCTs as low risk. Details of the randomisation procedure were missing for eight of the trials (Bornstein 1981; Goslinga 1992; Haass 1989; Hartmann 1987; HSSG 1989; Popa 1989; Rudolf 2002; Spudis 1973). …”

“…Blinding of participants was not possible in studies involving venesection. Information on blinding of participants, medical staff and evaluators was missing in four studies (Haass 1989; Hartmann 1987; HSSG 1989; Popa 1989). One study had high performance bias risk and unclear detection bias risk (Gilroy 1969), while another study had unclear performance bias risk and low detection bias risk (Spudis 1973).…”

“…In reports from 14 of the trials, it was clearly stated that blinded evaluators had been used (ALIAS-Part 1 2011; ALIAS-Part 2 2013; Balcarce 1991; Bornstein 1981; Frei 1987; IASSG 1988; Kaste 1976; Koller 1990; MAHST 1998; Mast 1991; Rudolf 2002; Spudis 1973; SSSG 1987; Strand 1984), whereas information on blinding was missing in the remaining seven (Gilroy 1969; Goslinga 1992; Haass 1989; Hartmann 1987; HSSG 1989; Matthews 1976; Popa 1989). …”

“…In people with brain infarction, intentional haemodilution has been associated with increased flow in the infarcted as well as in the contralateral hemisphere (Hartmann 1987; Vorstrup 1989; Wood 1983). This has also been amply shown in animal models of ischaemic stroke, in which beneficial results of haemodilution on infarct size have been demonstrated (Belayev 2001; Liu 2001).…”