Waxman K, Holness R, Tominaga G, Chela P, Grimes J
Department of Surgery, University of California, Irvine Medical Center, Orange 92668.
Ann Surg. 1989 Mar;209(3):341-5. doi: 10.1097/00000658-198903000-00015.
If nonprotein colloid plasma expanders could be demonstrated to be safe and efficacious in burn resuscitation, a significant cost benefit would result. This study was a randomized cross-over comparison of 500 ml of 5% albumin and 500 ml of 10% pentastarch, a new hydroxyethyl starch, in acute burn resuscitation. Pentastarch was an effective plasma expander, resulting in increases of preload, cardiac output, oxygen delivery, and oxygen consumption; the hemodynamic effects of pentastarch infusion were equal or superior to those of albumin. Both albumin and pentastarch infusions resulted in increased bleeding and clotting times; these effects were most likely dilutional. Pentastarch is a promising plasma substitute for burn resuscitation; the effects of a 500 ml infusion are equal or superior to those of albumin. Further study is necessary to assess the safety of larger infusion volumes.
如果能证明非蛋白胶体血浆扩容剂在烧伤复苏中安全有效，将会带来显著的成本效益。本研究是一项随机交叉比较试验，比较了500毫升5%白蛋白和500毫升10%喷他淀粉（一种新型羟乙基淀粉）用于急性烧伤复苏的效果。喷他淀粉是一种有效的血浆扩容剂，可增加前负荷、心输出量、氧输送和氧消耗；喷他淀粉输注的血流动力学效应等同于或优于白蛋白。白蛋白和喷他淀粉输注均导致出血和凝血时间延长；这些效应很可能是稀释性的。喷他淀粉是一种有前景的用于烧伤复苏的血浆替代品；500毫升输注量的效果等同于或优于白蛋白。有必要进一步研究以评估更大输注量的安全性。
