Pentastarch is a new synthetic hydroxyethyl starch similar to hetastarch. We report on the clinical comparisons the clinical efficacy and safety of 10% pentastarch in priming solutions for CPB in cardiac operations with that of 20% serum albumin.
During
CPB, group P(n=20) received 500ml of 10% pentastarch and group A(n=20) received 100ml of 20% albumin in priming solutions The postoperative time of ICU stay in group P and the day and amount of chest drain, hospital stay in group A were
longer(p<0.05).
Fresh whole blood and PRBC were added only in group A and a higher amount of hartman solution was added in group A during CPB(p<0.05). prothrombin time was prolonged preoperatively and 2 days postoperatively in group A and 7 days postoperatively
in
group P(p<0.05) but there were no significant difference in bleeding time or fibrinogen level.
Platelet count was higher immediately postoperatively in group A and preoperatively and 1, 2, and 7days postoperatively in group P(p<0.05). Total protein and albumin level were higher 1 day postoperatively in group A and 2 and 7 days
postoperatively in
group P(p<0.05). BUN was increased 2 days postoperatively in group A and Cr was increased 1 day postoperatively in group P(p<0.05). CPK was higher preoperatively and 1, 2, and 7 days postoperatively in group A and plasma hemoglobin level was also
higher
2 and 7 days postoperatively in group A(p<0.05). There were no significant differences in arterial blood gas analysis but higher pO2 and lower pCO2 levels were maintained in group P and ejection fraction was higher 7 days postoperatively in group
P(p<0.05).
Both groups were improved postoperatively in NYHA class and the hemodynamic parameters such as MAP, CO, CI, SV, LVSWI were well maintained in group P(p<0.05). The amount of blood products used was higher in group A and urine output was higher
immediately postoperatively in group A and 1, 2 days postoperatively in group P and the chest output was higher in group A. The complications were developed in 7 patients in group A and 5 patients in group P and mortality was not present in both
groups.
In conclusion, 10% pentastarch is as safe and effective as 20% albumin in prime solutions for cardiopulmonary bypass in cardiac operations. (Korean J Thoracic Cardiovas Surg 1994; 27:99-113)
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