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• W1789801172 abstract "Background Ischaemic stroke interrupts the flow of blood to part of the brain. Haemodilution is thought to improve the flow of blood to the affected areas of the brain and thus reduce infarct size. Objectives To assess the effects of haemodilution in acute ischaemic stroke. Search methods We searched the Cochrane Stroke Group Trials Register (last searched January 2002), MEDLINE (1966 to June 2002) and conference abstracts. We contacted manufacturers and investigators in the field to identify any additional published and unpublished studies. Selection criteria Randomised trials of haemodilution treatment in people with acute ischaemic stroke. Only trials in which treatment was started within 72 hours of stroke onset were included. Data collection and analysis Two reviewers assessed trial quality and independently extracted the data. Main results Eighteen trials were included. A combination of venesection and plasma volume expander was used in eight trials. Ten trials used plasma volume expander alone. The plasma volume expander was dextran 40 in 12 trials, hydroxyethyl starch (HES) in five trials and albumin in one trial. Two trials tested haemodilution in combination with another therapy. Evaluation was blinded in 11 trials. Five trials probably included some patients with intracerebral haemorrhage. Haemodilution did not significantly reduce deaths within the first four weeks (odds ratio 1.09, 95% confidence interval 0.86 to 1.38). Similarly, haemodilution did not influence deaths within three to six months (odds ratio (OR) 1.01, 95% confidence interval (CI) 0.84 to 1.22), or death and dependency or institutionalisation (OR 0.98, 95% CI 0.84 to 1.15). The results were similar in confounded and unconfounded trials, and in trials of isovolaemic and hypervolaemic haemodilution. No statistically significant benefits were documented for any particular type of haemodiluting agents, but the statistical power to detect effects of HES and albumin was weak. Six trials reported venous thromboembolic events. There was a tendency towards reduction in deep venous thrombosis and/or pulmonary embolism at three to six months follow‐up (OR 0.59, 95% CI 0.33 to 1.06). There was no increased risk of serious cardiac events among haemodiluted patients. Authors' conclusions The overall results of this review are compatible both with modest benefit and moderate harm of haemodilution therapy for acute ischaemic stroke. This therapy has not been proven to improve survival or functional outcome." @default.
• W1789801172 created "2016-06-24" @default.
• W1789801172 creator A5081602472 @default.
• W1789801172 date "2002-10-21" @default.
• W1789801172 modified "2023-10-01" @default.
• W1789801172 title "Haemodilution for acute ischaemic stroke" @default.
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• W1789801172 doi "https://doi.org/10.1002/14651858.cd000103" @default.
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