MICROCIRCULATORY LONG-TERM EFFECTS AFTER HYPERVOLEMIC AND ISOVOLAEMICHEMODILUTION IN PATIENTS WITH INTERMITTENT CLAUDICATION

Objectives: The aim of the present study was to clarify the possible l ong term effects in the course of different haemodilution regimes acco rding to the tissue oxygen supply in the lower limb muscle of patients with intermittent claudication. Methods: In order to simulate the sit uation of intermittent claudication muscle tissue pO(2) measurements w ere performed before and after a standardized pedal ergometric test. M uscle tissue pO(2) readings were performed using micro-pt-needle elect rodes at a work load of 5.7 +/- 0.2 Watt. We performed hypervolaemic h aemodilution as well as isovolaemic haemodilution intraindividually an d in order to compare these different regimes we have chosen the situa tion, when the haematocrit had returned to the pretreatment values. Re sults: Observing 4 weeks after the end of isovolaemic haemodilution th e red blood cell aggregation is significantly decreased, whereas the o ther haemorrheological variables remained unchanged. Furthermore muscl e tissue pO(2) values are increased at rest without improvement of the exercise-induced muscle tissue pO(2). In contrast there is no effect on haemorrheological variables as well as muscle tissue oxygen supply at rest and after pedal ergometric exercise test after the end of hype rvolaemic haemodilution. Conclusions: Our results suggest no benefit i n the course of a long-term hypervolaemic haemodilution therapy in pat ients with intermittent claudication. In contrast after isovolaemic ha emodilution there was found an increase in muscle tissue oxygen supply at rest without changing of the exercise-induced pattern. In our opin ion isovolaemic haemodilution is to prefer in the course of long-term haemodilution therapy.