Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
권호 표지

The Clinical Comparisons of 10% Pentastarch and 20% Albumin in Priming Solutions for Cardiopulmonary Bypass in Cardiac Operations

개심술중 심폐우회 충전용객속에서의 10% 펜타스타치와 20% 알부민의 임상 비교

  • Published : 1994.02.01
Download PDF
⟨ Previous Next ⟩

Abstract

Pentastarch is a new synthetic hydroxyethyl starch similar to hetastarch. We report on the clinical comparisons the clinical efficacy and safety of 10% pentastarch in prime solutions for CPB in cardiac operations with that of 20% serum albumin. During CPB, group P [n = 20] received 500ml of 10% pentastarch and group A [n = 20] received 100ml of 20% albumin in prime solutions The postoperative time of ICU stay in group P and the day and amount of chest drain, hospital stay in group A were longer [p<0.05]. Fresh whole blood and PRBC were added only in group A and a higher amount of hartman solution was added in group A during CPB [p<0.05]. Prothrombin time was prolonged preoperatively and 2 days postoperatively in group A and 7 days postoperatively in group P [p<0.05] but there were no significant differences in bleeding time or fibrinogen level. Platelet count was higher immediately postoperatively in group A and preoperatively and 1, 2, and 7 days postoperatively in group P [p<0.05].Total protein and albumin level were higher 1 day postoperatively in group A and 2 and 7 days postoperatively in group P [p<0.05]. BUN was increased 2 days postoperatively in group A and Cr was increased 1 day postoperatively in group P [p<0.05]. CPK was higher preoperatively and 1, 2, and 7 days postoperatively in group A and plasma hemoglobin level was also higher 2 and 7 days postoperatively in group A [p<0.05]. There were no significant differences in arterial blood gas analysis but higher pO2 and lower pCO2 levels were maintained in group P and ejection fraction was higher 7 days postoperatively in group P [p<0.05]. Both groups were improved postoperatively in NYHA class and the hemodynamic parameters such as MAP, CO, CI, SV, LVSWI were well maintained in group P [p<0.05]. The amount of blood products used was higher in group A and urine output was higher immediately postoperatively in group A and 1, 2 days postoperatively in group P and the chest output was higher in group A. The complications were developed in 7 patients in group A and 5 patients in group P and mortality was not present in both groups.In conclusion, 10% pentastarch is as safe and effective as 20% albumin in prime solutions for cardiopulmonary bypass in cardiac operations.

Keywords

References

  1. Pharmacology of hydroxyethyl starch : use in therapy and blood banking Mishler,J.M.
  2. Crit Care Med v.17 Effects of pentastarch and albumin infusion on cardiorespiratory function and coagulation in patients with severe sepsis and systemic hypoperfusion Rackow,E.C.;Mecher,C.;Astiz,M.E.;Griffel,M.;Falk,J.L.;Weil,M.H.
  3. Ann Thorac Surg v.34 Clinical comparison of hetastarch and albumin in postoperative cardiac patients Diehl,J.T.;Lester,J.L.;Cosgrove,D.M.
  4. Ann Thorac Surg v.37 Hydroxyethyl starch versus albumin of colloid infusion following cardiopulmonary bypass in patients undergoing myocardial revascularization Kirklin,J.K.;Lell,W.A.;Kouchoukos,N.T.
  5. J Trauma v.8 Clinical evaluation of a new plasma expander, hydroxyethyl starch Lee,W.H.Jr.;Cooper,N.;Weidner,M.G.Jr.(et al.)
  6. Ann Thorac Surg v.19 Clinical evaluation of priming solutions for pump oxygenator perfusion Lee,W.H.Jr.;Rubin,J.W.;Huggins,M.P.
  7. J Thorac Cardiovasc Surg v.84 Hydroxyethyl starch in priming fluid for cardiopulmonary bypass Sade,R.M.;Crawford,F.A.Jr.;Dearing,J.P.;Stroud,M.
  8. Transfusion v.25 Effects of hydroxyethyl starch on fibrinogen, fibrin clot formation, and fibrinolysis Strauss,R.G.;Stump,D.C.;Heinriksen,R.A.;Saunders,R.
  9. J Extra-Corp Tech. v.7 Hemodilution with hydroxyethyl starch during cardiopulmonary bypass : review of a multiinstitutional study Mishler,J.M.;Nicora,R.W.;Yoshitake,T.(et al.)
  10. Ann Thorac Surg v.34 Hetastarch as a prime for cardiopulmonary bypass Palanzo,D.A.;Parr,G.V.S.;Bull,A.P.;Williams,D.R.;O'Neill,M.J.;Waldhausen,J.A.
  11. Circulation v.41 Acute alterations of body composition after open intracardiac operations Pacifico,A.D.;Digerness,S.;Kirklin,J.W.
  12. Hydroxyethyl Starch, Blood Substitutes and Plasma Expanders Thompson,W.L.
  13. Crit Care Med v.8 Hemodynamic, blood volume, and oxygen transport responses to albumin and hydroxyethyl starch infusions in critically ill postoperative patients Lazrove,S.;Waxman,K.;Shippy,C.(et al.)
  14. J Clin Pathol v.33 Post-transfusion survival of hydroxyethyl starch 450/0.70 in man : a long term study Mishler,J.M.;Ricketts,C.R.;Parkhouse,E.J.
  15. J Thorac Cardiovasc Surg v.97 A randomized clinical trial of 10% pentastarch (low molecular weight hydroxyethyl starch) versus 5% albumin for plasma volume expansion after cardiac operations London,M.J.;Ho,J.S.;Triedman,J.K.(et al.)
  16. Crit Care Med v.15 Effects of three colloid solutions on plasma volume and hemodynamics after coronary bypass surgery Karanko,M.S.
  17. Crit Care Med v.12 Rewarming hypovolemia after aortocoronary bypass Ivanov,J.;Weisel,R.D.;Mickleborough,L.L.;Hilton,J.D.;McLaughlin,P.R.
  18. Br J Clin Pharmacol v.7 A clinical study of low molecular weight-hydroxyethyl starch, a new plasma volume expander Mishler,J.M.;Parry,E.S.;Sutherland,B.A.;Bushrod,J.R.
  19. Surg Gynecol Obstet v.131 Intravascular persistence, tissue storage, and excretion of hydroxyethyl starch Thompson,W.L.;Fukushima,T.;Rutherford,R.B.(et al.)
  20. Ann Surg v.209 Hemodynamic and oxygen transport effects of pentastarch in burn resuscitation Waxman,K.;Holness,R.;Tominga,G.;Chela,P.;Grimes,J.
  21. J Thorac Cardiovasc Surg v.73 The effects of cardiopulmonary bypass with colloid and colloid hemodilution on myocardial extravascular water Laks,H.;Standaven,J.;Blair,O.;Hahn,J.;Jellinek,M.;William,V.L.
  22. J Thorac Cardiovasc Surg v.69 Lung water accumulation with acute hemodilution in dogs Cooper,J.D.;Maeda,M.;Lowenstein,E.
  23. J Lab Clin Med v.73 The effect of plasma proteins on the interaction of platelets with glass surfaces Packham,M.A.;Evans,G.;Glynn,M.F.;Mustard,J.F.
  24. Ann Thorac Surg v.36 Hydroxyethyl starch versus albumin in cardiopulmonary bypass prime solutions Saunders,C.R.;Carlisle,L.;Bick,R.L.
  25. J Thorac Cadiovasc Surg v.56 Alterations in fibrinolysis and coagulation associated with cardiopulmonary bypass Porter,J.M.;Silver,D.
  26. Transfusion v.28 Pentastarch may cause fewer effects on coagulation than hetastarch Strauss,R.G.;Stansfield,C.;Henriksen,R.A.;Villhauer,P.J.
  27. J Thorac Cardiovasc Surg v.60 Bleeding patterns after open-heart surgery Gomes,M.M.R.;McGoon,D.C.
  28. J Urol v.93 The renal and systemic effects of hydroxyethyl starch solution effusions Murphy,G.P.;Demaree,D.E.;Gagnon,J.A.
  29. Surg Gynecol Obstet v.128 Use of hydroxyethyl starch solution in extensive surgical operations Gollub,S.;Schechter,D.C.;Hirose,T.(et al.)
  30. Lancet v.1 Incidence and severity of anaphylactoid reactions to colloid volume substitutes Ring,J.;Messmer,K.