Pentastarch
Pentastarch is a synthetic derivative of starch, which has five hydroxyethyl groups.
It is sold under the name Pentaspan and used for fluid resuscitation. It is considered a plasma expander because it remains primarily intravascular after infusion.
Choice of resuscitation fluid
The choice of fluid (normal saline vs. Ringer's lactate vs. pentaspan) is controversial.[1]
Physiologically, fluid with pentaspan stays primarily in the blood plasma. This is different than normal saline, which shifts quickly into the intracellular compartment.
Advocates of pentaspan use believe that:
- the primary deficit in fluid resuscitation is intravascular volume loss[1] and
- use of normal saline may lead to pulmonary edema, particularily in older patients.[1]
Normal saline versus pentastarch
Casualty
Pentastarch in the emergency setting does not give a survival advantage; however, significantly less volume is required for resuscitation.[2]
Cardiac surgery
A study is currently being done to compare normal saline with pentastarch following cardiac surgery.[3]
Cost
Pentastarch is more expensive than normal saline, but less expensive than albumin.
References
- ↑ 1.0 1.1 1.2 Falk JL, Rackow EC, Weil MH (1983). "Colloid and crystalloid fluid resuscitation". Acute care. 10 (2): 59–94. PMID 6085668.
- ↑ Younes RN, Yin KC, Amino CJ, Itinoshe M, Rocha e Silva M, Birolini D (1998). "Use of pentastarch solution in the treatment of patients with hemorrhagic hypovolemia: randomized phase II study in the emergency room". World journal of surgery. 22 (1): 2–5. PMID 9465753.
- ↑ Double Blind Randomized Trial of Saline vs Pentaspan for Resuscitation After Cardiac Surgery. ClinicalTrials.gov. URL: http://clinicaltrials.gov/show/NCT00337805. Accessed on: July 21, 2007.
See also
External links
- Pentaspan monograph - rxmed.com.
- Structure of Pentaspan.