- 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 primarilyintravascular after infusion.Choice of resuscitation fluid
The choice of fluid (normal saline vs.
Ringer's lactate vs. pentaspan) is controversial.cite journal |author=Falk JL, Rackow EC, Weil MH |title=Colloid and crystalloid fluid resuscitation |journal=Acute care |volume=10 |issue=2 |pages=59–94 |year=1983 |pmid=6085668 |doi=]Physiologically, fluid with pentaspan stays primarily in the intravascular space -
blood plasma . This is different than normal saline, which shifts quickly into the rest of the extracellular compartment.Advocates of pentaspan use believe that:
# the primary deficit in fluid resuscitation is intravascular volume loss and
# use of normal saline may lead to pulmonary edema, particularly in older patients.Normal saline versus pentastarch
Casualty
Pentastarch in the emergency setting is not well studied and its use not of proven benefit. One small study, comparing normal saline and pentastarch, failed to show any significant survival advantage; however, significantly less volume was required for resuscitation in the pentastarch group. [cite journal |author=Younes RN, Yin KC, Amino CJ, Itinoshe M, Rocha e Silva M, Birolini D |title=Use of pentastarch solution in the treatment of patients with hemorrhagic hypovolemia: randomized phase II study in the emergency room |journal=World journal of surgery |volume=22 |issue=1 |pages=2–5 |year=1998 |pmid=9465753 |doi=]
Cardiac surgery
A study is currently being done to compare
normal saline with pentastarch followingcardiac surgery . [Double Blind Randomized Trial of Saline vs Pentaspan for Resuscitation After Cardiac Surgery. ClinicalTrials.gov. URL: [http://clinicaltrials.gov/show/NCT00337805 http://clinicaltrials.gov/show/NCT00337805] . Accessed on: July 21, 2007.]Cost
Pentastarch is more expensive than normal saline, but less expensive than
albumin .References
ee also
*
Intravenous therapy External links
* [http://www.rxmed.com/b.main/b2.pharmaceutical/b2.1.monographs/CPS-%20Monographs/CPS-%20(General%20Monographs-%20P)/PENTASPAN.html Pentaspan monograph] - rxmed.com.
* [http://pentaspan.homestead.com/ Structure of Pentaspan] .
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