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Influence of a Long-Term, High-Dose Volume Therapy with 6% Hydroxyethyl Starch 130/0.4 or Crystalloid Solution on Hemodynamics, Rheology and Hemostasis in Patients with Acute Ischemic Stroke
Results of a Randomized, Placebo-Controlled, Double-Blind StudyWoessner R.a · Grauer M.T.a · Dieterich H.-J.b · Bepperling F.c · Baus D.c · Kahles T.d · Georgi S.d · Bianchi O.d · Morgenthaler M.a · Treib J.a
aDepartment of Neurology, Westpfalz Klinikum, University City of Kaiserslautern, Kaiserslautern, bDepartment of Anaesthesiology, University of Tübingen, Tübingen, cDepartment of Clinical Research, Fresenius Kabi, Deutschland GmbH, Bad Homburg, dDepartment of Neurology, University of the Saarland, Homburg/Saar, Germany Corresponding Author
Priv.-Doz. Dr. med. Johannes Treib, MD
Department of Neurology
Westpfalz-Klinikum GmbH, University Teaching Hospital
DE–67655 Kaiserslautern (Germany)
Tel. +49 631 203 1792, Fax +49 631 203 1977, E-Mail firstname.lastname@example.org
Background: This study was performed to investigate the clinical effects of a 4-day volume therapy with a newly developed, 6% hydroxyethyl starch (HES) 130/0.4 versus crystalloid solution, with particular regard to systemic and cerebral hemodynamics, rheology and safety. Methods: In a randomized, double-blind study, 40 patients suffering from an acute ischemic stroke received either 6% HES 130/0.4 or crystalloid solution as continuous infusion over 4 days with a total dose of 6.5 liters. Efficacy parameters studied included hemodynamics (cardiac output, blood pressure, flow velocity with transcranial Doppler) and rheology (hematocrit and plasma viscosity). Safety parameters examined included laboratory, hemostaseology (including factor VIII) and an adverse event questionnaire (including pruritus). Results: In both groups, a small, but not significant increase in cardiac output was observed. There were no significant changes regarding the remaining efficacy or safety parameters, except for the well-known increase in serum alpha-amylase through the infusion of HES. Conclusion: In our study with patients suffering from acute ischemic stroke, continuous infusion (1 ml/min) of HES 130/0.4 or crystalloid solution did not differ regarding safety or hemodynamic efficacy.
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