Pentastarch

Pentastarch is a synthetic derivative of starch, which has five hydroxyethyl groups.

It is sold under the name Pentaspan and used for fluid resuscitation. It is considered a plasma 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, fluid with pentaspan stays primarily in the blood plasma. This is different than normal saline, which shifts quickly into the intracellular 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, particularily in older patients.

Casualty
Pentastarch in the emergency setting does not give a survival advantage; however, significantly less volume is required for resuscitation.

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

Cost
Pentastarch is more expensive than normal saline, but less expensive than albumin.