A COMPARISON OF 10-PERCENT PENTASTARCH AND 5-PERCENT ALBUMIN IN PATIENTS UNDERGOING OPEN-HEART-SURGERY

Colloids are useful in cardiac surgery to increase preload and improve cardiac output without the risks associated with blood transfusions. Pentastarch is a new low-molecular weight hydroxyethyl starch compound under investigation for this purpose. The authors compared, in a rand omized fashion, 17 patients who received pentastarch and 17 patients w ho received albumin for volume expansion after open-heart surgery. Dur ing the 24-hour study period there was no significant difference betwe en the two groups with respect to systemic blood pressure, mean arteri al pressure, cardiac index, right atrial pressure, and pulmonary capil lary wedge pressure, with the exception of a higher mean arterial pres sure and systolic blood pressure at 4 hours in the albumin group and h igher heart rate at 12 hours in the pentastarch group. In addition, po stoperative prothrombin time, partial thromboplastin time, fibrinogen, platelets, and factor VIII levels were not significantly different be tween the two groups, There were no complications attributed to colloi d administration. The hemodynamic parameters were further evaluated in a subset of 6 pentastarch and 9 albumin patients who received the fir st 500 mL of colloid in a similar time frame and under similar clinica l conditions. The patients who received pentastarch showed a significa ntly greater increase in cardiac index than did the patients who recei ved albumin. No significant change in other parameters were noted betw een the two groups. The authors conclude that pentastarch is as safe a s albumin and may be a more effective volume expander than albumin whe n used in open-heart surgery patients.