Clinical use of pentastarch in cardiac surgery without homologous blood transfusion.
In an attempt to avoid the use of homologous blood transfusion, we used pentastarch 6% or 10% in a consecutive series of open heart surgery. After induction of anesthesia, whole blood 500 cc was withdrawn from the patient via an artery line, and 6% or 10% pentastarch 500 cc was infused simultaneously via a central venous line. A further 500 cc pentastarch was placed in the heart-lung machine as a priming solution. After the operation the autologous blood was transfused. Pentastarch 500cc was also infused in the intensive care unit as a plasma expander. Significant improvements in cardiac output with decrease in hematocrit, plasma viscosity, systemic and pulmonary vascular resistance were noted after pentastarch infusion, due to its hemodiluting effects. Patients treated with pentastarch did not require transfusion of homologous blood, and they also displayed no abnormal coagulopathy, or increased amounts of postoperative bleeding during hospitalization. All patients were discharged without additional hospital stay. With the aid of pentastarch, acute normovolemic hemodilution can be performed safely in cardiac surgery with the advantages of saving stored blood, reducing the risks associated with homologous blood transfusion and profiting from hemodilution. It is therefore concluded that cardiac surgery can be performed safely with 6% or 10% pentastarch without any homologous blood transfusion.
Wang
S S
SS
Department of Surgery, National Taiwan University Hospital, Taipei, ROC.
Chu
S H
SH
Lin
H M
HM
Tsai
C H
CH
D000328:Adult; D001804:Blood Transfusion, Autologous; D006348:Cardiac Surgical Procedures; D005260:Female; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage*; D007263:Infusions, Parenteral; D008297:Male
D006895:Hydroxyethyl Starch Derivatives