Use of Pentastarch Solution in the Treatment of Patients with Hemorrhagic Hypovolemia: Randomized Phase II Study in the Emergency Room

Abstract. This study evaluates the hemodynamic effects of the administration of 10% pentastarch solution (PS) during the initial treatment of hypovolemia in trauma patients. This prospective randomized phase II study included 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 boluses, repeated until SBP > 100 mmHg. Blood pressure, infused volumes necessary 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 patients (1420 ± 298 ml) than in PS patients (356 ± 64 ml). No blood was transfused into PS patients, compared to 370 ± 140 ml of red blood cells transfused into IS patients ( p = 0.015). Mortality rates were similar in the two groups ( p = 0.725). We concluded that PS is a safe, efficient method for inducing hemodynamic recovery of hypovolemic trauma patients, with a clear reduction in the intravenous volumes required for acute resuscitation.