Ten percent pentastarch is a low-molecular weight hydroxyethyl starch with greater oncotic pressure and shorter intravascular persistence than 6% hetastarch. The purpose purpose of this study was to determine the safety and efficacy of
pentastarch
as a
plasma-volume expander as compared to plasmanate infusion in patients undergoing heart surgery. We were particularly interested in assessing hemodynamic responses and effects of pentastarch on bleeding and coagulation, and prospectively studied
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patients undergoing open heart surgery or coronary revascularization. 12 patients were randomized to receive 10ml/kg of either plasmanate (group Ⅰ) or 10% pentastarch (group Ⅱ) and simultaneously to predonate the blood as the same amounts of
colloid
solution.
Hemodynamic and coagulation profiles were measured after induction of anesthesia and 5min and 30min after following colloid infusion.
The effects of colloid infusion with pentastarch on hemodynamic profiles (hear rate, mean arterial pressure, mean pulmonary arterial pressure, cardiac index, pulmonary capillary wedge pressure, central venous pressure, systemic venous resistance,
pulmonary venous resistance) were not significantly different from those of plasmanate. The studies for five patients in plasmanate group were stopped because of severe hypotension during colloid infusion. The decrease in hemoglobin and platelet
count
were significantly greater in the pentastarch group than in the plasmanate group. Changes in PT, aPTT, serum osmolarity, PaO2 and PvO2 were similar between the two groups.
We conclude that pentastarch is a safe and effective colloid as similar to plasmanate to use as a plasma-volume expander.
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