[Effect of hemodilution with 10% hydroxyethyl starch solution (MW 200,000/9.5) on the flow properties of blood, arterial blood gases and conjunctival oxygen partial pressure in patients with cerebral infarct].

Hemorheological parameters, arterial blood gases and conjunctival oxygen tension were measured in 15 patients with acute ischemic stroke and compared with values obtained in an age matched reference group. Since the conjunctival capillary bed is perfused by the ophthalmic artery, it reflects the oxygen delivery to the areas supplied by the internal carotid artery. Measurements of conjunctival oxygen tension are simple and safe. Patients with acute ischemic stroke showed a lowered conjunctival oxygen tension; this holds true especially to the ipsilateral side, i.e. the side where the attack occurred, and to a lesser extent to the other side. By contrast, the ratio of arterial/conjunctival pO2 was disturbed only on the ipsilateral side. Furthermore, these patients had pathologically elevated values for red cell aggregation, whole blood and plasma viscosity. After infusing 500 ml 10% middle-molecular-weight hydroxyethyl starch (10% HAES-steril) and phlebotomy (250 ml) blood fluidity was normalized, although the hematokrit was only slightly reduced. Arterial pO2 improved slightly while pCO2 remained unchanged. Conjunctival oxygen tension improved by 30% on the ipsilateral and by 10% on the contralateral side, the ipsilateral values always remaining significantly lower. The ratio conjunctival/arterial pO2 raised only on the ipsilateral side where it was below the reference range before hemodilution. In addition to the well known improvement of blood fluidity and augmentation of cerebral blood flow following hemodilution in patients with acute ischemic stroke, there seems to be an increase in oxygen supply in the territories of both internal carotid arteries, especially on the ipsilateral side as indicated by the values of conjunctival oxygen tension and the ratio of conjunctival to arterial pO2.