Pentastarch is a subgroup of hydroxyethyl starch

Hydroxyethyl starch

Hydroxyethyl starch is a nonionic starch derivative. It is one of the most frequently used volume expander under the trade names Hespan by B. Braun Medical Inc...

, with five hydroxyethyl groups.

It is sold under the name Pentaspan and used for fluid resuscitation. It is considered a plasma

Blood plasma

Blood plasma is the straw-colored liquid component of blood in which the blood cells in whole blood are normally suspended. It makes up about 55% of the total blood volume. It is the intravascular fluid part of extracellular fluid...

 expander because it remains primarily intravascular after infusion.

Choice of resuscitation fluid

The choice of fluid (normal saline vs. Ringer's lactate vs. pentaspan) is controversial.

Physiologically

Physiology

Physiology is the science of the function of living systems. This includes how organisms, organ systems, organs, cells, and bio-molecules carry out the chemical or physical functions that exist in a living system. The highest honor awarded in physiology is the Nobel Prize in Physiology or...

, fluid with pentaspan stays primarily in the intravascular space - blood plasma

Blood plasma

Blood plasma is the straw-colored liquid component of blood in which the blood cells in whole blood are normally suspended. It makes up about 55% of the total blood volume. It is the intravascular fluid part of extracellular fluid...

. This is different than normal saline, which shifts quickly into the rest of the extracellular compartment.

Advocates of pentaspan use believe that:

1. the primary deficit in fluid resuscitation is intravascular volume loss and
2. use of normal saline may lead to pulmonary edema, particularly in older patients.

Casualty

Pentastarch in the emergency setting is not well studied and its use not of proven benefit. One small study, comparing normal saline and pentastarch, failed to show any significant survival advantage; however, significantly less volume was required for resuscitation in the pentastarch group.

Cardiac surgery

A study is currently being done to compare normal saline with pentastarch following cardiac surgery

Cardiac surgery

Cardiovascular surgery is surgery on the heart or great vessels performed by cardiac surgeons. Frequently, it is done to treat complications of ischemic heart disease , correct congenital heart disease, or treat valvular heart disease from various causes including endocarditis, rheumatic heart...

.

External links

• Pentaspan monograph - rxmed.com.
• Structure of Pentaspan.