[Distal obliterating arteriopathy of the lower limbs in a systemic disease. Treatment with normovolemic hemodilution. [Report of one case]].

The authors report on a 31 year old man with a generalised illness consisting of: buccal aphthous ulcers, distal arteriopathy, multiform cutaneous lesions (necrotising vasculitis, folliculitis, nodules), hypersensitivity at the site of puncture, Raynaud's syndrome and superficial venous thromboses. After the failure of various therapies (calcium heparin, ticlopidine, colchicine, corticoids, immunostimulants), the patient was successfully treated by normovolemic haemodilution on 20 occasions, obtaining each time healing of the skin lesions within 2 to 4 weeks.

[Simulation of transcapillary exchange of liquids].

The transcapillary exchanges of liquids between vascular and interstitial sections can be described with the help of a mathematical model describing variation in filtration, reabsorption, plasmatic flux and lymphatic flow in relation to the different active pressures, that is to say the arteriolar and venular pressures, the oncotic pressures of the proteins, and interstitial pressure. Also taking into account the modifications of the volemia in relation to blood loss and perfusions, modifications of the essential haemodynamic variables and diuresis, it is possible to reproduce various situations following the reduction in venous or lymphatic return, hypovolemia, and hypoproteinemia. The advantages in these simulations is demonstrated by the example of a blood depletion, compensated or otherwise, as follows: volemia, proteinemia, lymphatic flow.

[Hemodilution and pain].

The combination of the different chemical mediators likely to promote pain is often at the root of disturbances affecting both microcirculation and capillary permeability, as several studies have shown. These same disturbances are to be encountered in different types of illnesses in which pain dominates the clinical picture. Recent theoretical and experimental studies have also suggested that haemodilution might have beneficial effects on these rheological disorders.