HEMODYNAMICS OF STROKE PATIENTS UNDER THERAPY WITH LOW-MOLECULAR-WEIGHT HYDROXYETHYL STARCH

In stroke penumbra perfusion depends passively on hemodynamics. So far hemodynamic effects of low molecular weight hydroxyethylstarch (HES) has not been investigated. Ten stroke patients received hypervolemic H ES therapy. Cardiac output and heart rate were monitored using the bio impedance method, blood pressure by conventional measurement. The Scan dinavian Stroke Scale assessed clinical outcome. Circadian cardiac out put changes were measured in 20 controls. Patients' cardiac output inc reased after the loading dose (5.3 +/- 1.4 l min(-1) to 6.5 +/- 1.7) l min(-1), p < 0.01), fluctuating then between 5 and 7 l min(-1) withou t nocturnal decrease. Beside an initial increase, the heart rate showe d, like blood pressure, no remarkable changes. The Scandinavian Stroke Scale score did not change significantly. The controls showed a circa dian cardiac output fluctuation (2.00 am, 5.3 +/- 0.3 l min(-1); 8.30 am, 8.1 +/- 0.6 l min(-1)). Our patients showed a hemodynamic and clin ical stabilization under therapy with low molecular weight HES. The ph ysiological nocturnal decrease of cardiac output and blood, which migh t cause clinical deterioration in stroke patients, was avoided.