Hypervolemic hemodilution with or without venesection in peripheral arterial occlusive disease stage II.

Patients with peripheral arterial occlusive disease (PAOD) and marked atherosclerosis often present concomitant diseases like coronary heart disease, cerebral circulatory disorders or arterial hypertension. Thus, the extent of hypervolemia is limited in case of an infusion treatment without venesection. Therefore, it was tested whether a hypervolemic hemodilution without venesection is superior to a dilution with venesection in multimorbid patients suffering from PAOD stage II. The colloidal iso-molar solution used was Haes 200/0.5 6%. Both forms of hemodilution were significantly superior compared to a control group well hydrated with cristalloid saline solution; all groups practised walking exercise twice a week over a period of one hour. However, hypervolemic hemodilution without venesection was only slightly better than the dilution with venesection. The walking distance in the group without venesection increased by 68.6 m (36.7%) in the group without venesection, by 59.0 (30.4%) in the group with venesection and by 33.6 m (20.1%) in the control group. The results show that the decision to perform a hyperor isovolemic hemodilution should depend on the volume tolerance of each patient.