The effect of small hematocrit (Hct) increases on cardiac index (cardiac output / body weight) and oxygen release to the microcirculation was investigated in the awake hamster window chamber model, by means of exchange transfusions of homologous packed red blood cells. Increasing Hct between 8-13% from baseline increased cardiac index by 5 - 31% from baseline (P < 0.05) and significantly lowered systemic blood pressure (P < 0.05). The relationship between Hct and cardiac index is described by a second order polynomial (R² = 0.84; P < 0.05) showing that Hct increases up to 20% from baseline increase cardiac index whereas increases over 20% from baseline decrease cardiac index. Combining this data with measurements of blood pressure allowed to determine total peripheral vascular resistance which was a minimum at 8 - 13% Hct increase and was described by a second order polynomial (R² = 0.83; P < 0.05). Oxygen measurements in arterioles, venules and the tissue at 8 - 13% Hct increase were identical to control, thus as a consequence of increased flow and oxygen carrying capacity, oxygen delivery and extraction increased but the change was not statistically significant. Previous results with the same model showed that the observed effects are related to shear stress mediated release of nitric oxide (NO), an effect that should be also present in the heart microcirculation, leading to increased blood flow, myocardial oxygen consumption and contractility. We conclude that a minimum viscosity level is necessary for generating the shear stress required for maintaining normal cardiovascular function.