Nagy K K, Davis J, Duda J, Fildes J, Roberts R, Barrett J
Division of Trauma, Cook County Hospital, Chicago, IL 60612.
Circ Shock. 1993 Aug;40(4):289-94.
Pentastarch is a colloid that is chemically similar to Hetastarch. It has a shorter half-life (12 hr), and produces volume expansion at least 1.5 times the administered volume. We compared Pentastarch to Ringer's lactate in 41 patients (21 Pentastarch, 20 Ringer's lactate) presenting with hemorrhagic shock. The groups were similar in age, sex, race, and type of injury. Significantly less volume of Pentastarch was required initially to resuscitate to a normal blood pressure and urine output than Ringer's lactate (P < 0.005). Coagulation parameters (prothrombin time, partial thromboplastin time, fibrinogen, and factor VIII) were measured for 48 hr post-resuscitation, and no abnormalities were noted in the Pentastarch group. Serum albumin was the same in both groups throughout the study period; however, serum colloid oncotic pressure was elevated at 1 hr post-resuscitation in the Pentastarch group (P < 0.005). There was no difference in ventilatory parameters, blood gases, pulmonary function tests, ventilator days, or hospital days between the two groups. We conclude that Pentastarch is safe and effective for the initial resuscitation from hemorrhagic shock.
喷他淀粉是一种胶体，在化学性质上与羟乙基淀粉相似。它的半衰期较短（12小时），扩容效果至少为给药量的1.5倍。我们将41例失血性休克患者（21例使用喷他淀粉，20例使用乳酸林格液）的喷他淀粉与乳酸林格液进行了比较。两组在年龄、性别、种族和损伤类型方面相似。与乳酸林格液相比，最初复苏至正常血压和尿量所需的喷他淀粉量显著更少（P<0.005）。复苏后48小时测量凝血参数（凝血酶原时间、部分凝血活酶时间、纤维蛋白原和因子VIII），喷他淀粉组未发现异常。在整个研究期间，两组的血清白蛋白水平相同；然而，喷他淀粉组复苏后1小时血清胶体渗透压升高（P<0.005）。两组在通气参数、血气、肺功能测试、机械通气天数或住院天数方面没有差异。我们得出结论，喷他淀粉用于失血性休克的初始复苏是安全有效的。
