Pentaspan is 10% pentastarch in 0.9% sodium chloride. It is an artificial colloid (hydroxyethyl starch derivative).
The primary intended use of Pentaspan is as a substitute for older colloids such as albumin for use in plasma volume expansion. A number of clinical studies have demonstrated the safety of Pentaspan for plasmapheresis, vascular surgery, cardiopulmonary bypass, resuscitation after major burns or during sepsis syndrome, and hemodilution therapy after stroke.
Pentastarch is administered via the intravenous route. The usual dose administered for the purposes of plasma volume expansion is 500 to 1000 mL, and should not to exceed 2000 mL daily under ordinary circumstances.
As a result of its lower molecular weight and lesser degree of substitution, pentastarch is eliminated from the circulation at a faster rate than hetastarch. Ordinarily, only 10% of an intravenous dose remains after 24 hours, and levels are undetectable after 4 to 7 days.
Pentastarch is hydrolyzed by plasma amylase, and this is more rapid and complete compared to hetastarch. Up to 70% of a dose is excreted in the urine within 24 hours. The elimination half-life of pentastarch is approximately 2.5 hours, which is substantially shorter than that of hetastarch.
Potential adverse effects include hemostatic abnormalities (eg, prolonged prothrombin time and activated partial thromboplastin time (aPTT), and reductions in platelet counts, hemoglobin, and factor VIII levels). This is at least partly as a result of hemodilution. The effects on hemostasis are less than those observed with hetastarch. Other potential adverse effects include hypersensitivity reactions (rare), edema, weight gain, headache, fatigue, and nausea.
Most of an infused dose of pentastarch is excreted in the urine. Prudence dictates that one avoid pentastarch in patients with renal disease complicated by oliguria or anuria unless it is related to hypovolemia.
