Hemodynamic and oxygen transport effects of pentastarch in burn resuscitation.
If nonprotein colloid plasma expanders could be demonstrated to be safe and efficacious in burn resuscitation, a significant cost benefit would result. This study was a randomized cross-over comparison of 500 ml of 5% albumin and 500 ml of 10% pentastarch, a new hydroxyethyl starch, in acute burn resuscitation. Pentastarch was an effective plasma expander, resulting in increases of preload, cardiac output, oxygen delivery, and oxygen consumption; the hemodynamic effects of pentastarch infusion were equal or superior to those of albumin. Both albumin and pentastarch infusions resulted in increased bleeding and clotting times; these effects were most likely dilutional. Pentastarch is a promising plasma substitute for burn resuscitation; the effects of a 500 ml infusion are equal or superior to those of albumin. Further study is necessary to assess the safety of larger infusion volumes.
Waxman
K
K
Department of Surgery, University of California, Irvine Medical Center, Orange 92668.
Holness
R
R
Tominaga
G
G
Chela
P
P
Grimes
J
J
D000328:Adult; D000418:Albumins / Q000627:therapeutic use*; D001777:Blood Coagulation / Q000187:drug effects; D002056:Burns / Q000628:therapy*; D003102:Colloids; D005260:Female; D005440:Fluid Therapy; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000627:therapeutic use*; D008297:Male; D010100:Oxygen / Q000097:blood; D010952:Plasma Substitutes / Q000627:therapeutic use*; D011897:Random Allocation; D012151:Resuscitation; D013213:Starch / Q000031:analogs & derivatives*
D000418:Albumins; D003102:Colloids; D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes; D013213:Starch; D010100:Oxygen