Effects of Plasmanate and Pentastarch Infusion on Hemodynamic and Coagulation in Patients Undergiong Heart Surgery

Chung, Nam Young; Ham, Byung Moon

Abstract

Ten percent pentastarch is a low-molecular weight hydroxyethyl starch with greater on- cotic pressure and shorter intravascular persistence than 6% hetastarch The purpose of this study was to determine the safety and efficacy of pentastarch as a plasma-volume expand- er as compared to plasmanate infusion in patients undergoing heart surgery. We were par- ticularly interested in assesaing hemodynamic responses and effects of pentastarch on bleeding and coagulation, and prospectively studied 24 patients undergoing open heart surgery or coronary revascularization. 12 patients were randomized to receive 10ml/kg of either plasmanate(group I) or 10% pentastarch(group II) and simultaneously to predonate the blood as the same amounts of colloid solution. Hemodynamic and coagulation profiles were measured after induction of anestheaia and 5min and 30min after following colloid infusion. The effects of colloid infusion with pentaatarch on hemodynamic profiles(heat rste, mean arterial p ure, mean pulmonary arterial preasure, cardiac index, pulmonary capillary wedge pressure, central venous pressure, systemic venous resistsnce, pulmonary venous resistance) were not significantly different from those of plasmanate. The studies for five patients in plasmanate group were stopped because of severe hypotension during colloid infusion. The decrease in hemoglobin and platelet count were significantly greater in the pentastarch group than in the plasmanate group. Changes in PT, aPTT, serum osmolarity, PaO2 and PvO2, were similar between tbe two groups. We conclude that pentastarch is a safe and effective colloid as similar to plasmarate to use as a plasma-volume expander.