Pentastarch
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It has been suggested that this article or section be merged into hydroxyethyl starch. (Discuss) |
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.
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
