USE OF PENTASTARCH SOLUTION IN THE TREATMENT OF PATIENTS WITH HEMORRHAGIC HYPOVOLEMIA - RANDOMIZED PHASE-II STUDY IN THE EMERGENCY ROOM

This study evaluates the hemodynamic effects of the administration of 10% pentastarch solution (PS) during the initial treatment of hypovole mia in trauma patients. This prospective randomized phase II study inc luded trauma patients admitted to the emergency room with hemorrhagic hypovolemia: systolic blood pressure (SBP) < 90 mmHg. Upon admission, the patients were randomized to receive 10% PS (n = 12) or isotonic 0. 9% NaCl solution (IS) (n = 11), infused intravenously in 250-ml boluse s, repeated until SBP > 100 mmHg. Blood pressure, infused volumes nece ssary to maintain SBP, and overall survival rates were determined and compared between groups. SBP increased significantly following either IS (from 64.4 +/- 9.2 mmHg to 111.1 +/- 6.3 mmHg), or PS (from 63.7 +/ - 10.6 mmHg to 108.1 +/- 9.8 mmHg) when compared to admission values ( p < 0.05). Endovenous volumes infused were greater (p = 0.001) in IS p atients (1420 +/- 298 ml) than in PS patients (356 +/- 64 ml). No bloo d was transfused into PS patients, compared to 370 +/- 140 ml of red b lood cells transfused into IS patients (p = 0.015). Mortality rates we re similar in the two groups (p = 0.725). We concluded that PS is a sa fe, efficient method for inducing hemodynamic recovery of hypovolemic trauma patients, with a clear reduction in the intravenous volumes req uired for acute resuscitation.