Normovolemic hemodilution in peripheral arterial disease.

In 25 patients with arterial occlusive disease in clinical stage IV (Fontaine) a normovolemic hemodilution to an average hematocrit of 0.31 +/- 0.02 was performed. Eighteen patients had peripheral ulcers of the lower limbs and three had ulcers of the upper limbs. Four patients had lesions of both hands and feet. The average age of the patients was 43. Hemodilution was achieved by repeated withdrawals of approximately 500 ml of blood, followed by reinfusion of the autologous plasma and infusion of low-molecular weight dextran solution to avoid hypovolemia. In all patients with peripheral ulcers of the upper limbs, a good to a very good clinical effect was obtained. The healing tendency of lesions on the feet and toes were less marked and depended basically on the total number of vascular impediments. The rheological and hemodynamic basis of the therapeutic effect of hemodilution and the preliminary criteria for indicating this therapy are discussed.