Effects of pentastarch and albumin infusion on cardiorespiratory function and coagulation in patients with severe sepsis and systemic hypoperfusion.
Twenty consecutive patients with severe sepsis were randomized to fluid challenge with 5% albumin or 10% low MW hydroxyethyl starch (pentastarch) solutions. Fluid challenge was administered iv as 250 ml of test colloid every 15 min until the pulmonary artery wedge pressure (WP) was greater than or equal to 15 mm Hg or a maximum dose of 2000 ml was infused. Hemodynamic, respiratory, and coagulation profiles were measured before and after fluid infusion. The amount of colloid required to achieve a WP of 15 mm Hg was comparable between groups. Both colloid infusions resulted in similar increases in cardiac output, stroke output, and stroke work. The effect of fluid infusion with pentastarch on coagulation was not significantly different from albumin, although pentastarch was associated with a 45% decrease in factor VIII:c. We conclude that pentastarch is equivalent to albumin for fluid resuscitation of patients with severe sepsis.
Rackow
E C
EC
Department of Medicine, University of Health Sciences, Chicago Medical School, IL 60064.
Mecher
C
C
Astiz
M E
ME
Griffel
M
M
Falk
J L
JL
Weil
M H
MH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000418:Albumins / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D001775:Blood Circulation / Q000187:drug effects; D001777:Blood Coagulation / Q000187:drug effects*; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011897:Random Allocation; D012119:Respiration / Q000187:drug effects*; D012129:Respiratory Function Tests; D013213:Starch / Q000031:analogs & derivatives*
D000418:Albumins; D006895:Hydroxyethyl Starch Derivatives; D013213:Starch