Vetdrugs 2.0Pentastarch is a hydroxyethyl starch colloid used for intravascular volume expansion. It consists of modified glucose polymers with a degree of substitution and size profile that influence persistence and breakdown. Veterinary applications have involved selected acute hypovolemic patients, while evidence for an outcome advantage over other resuscitation fluids remains uncertain.
Group
Synthetic colloid volume expander
Mechanism of Action
Pentastarch increases colloid osmotic pressure within the circulation while sufficient polymer remains intravascular. This favors retention of water and plasma-volume expansion, potentially improving venous return and cardiac output. Enzymatic degradation, renal elimination and movement across the vascular barrier determine the duration and distribution of the effect. These factors vary with formulation and patient physiology.
Dose Rates
Dogs
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Volume expansion | Reference only | IV | 10-25 mL/kg/day IV as continuous infusion. |
Cats
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Volume expansion | Reference only | IV | 5-10 mL/kg/day IV as continuous infusion. |
Horses
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Volume expansion | Reference only | IV | 8-15 mL/kg IV or continuous infusion at 0.5-1 mL/kg/hour. |
Indications
- Selected short-term volume expansion in veterinary patients with acute hypovolemia or hypovolemic shock, with uncertain evidence of improved clinical outcomes.
Adverse effects
- Allergic reactions, renal dysfunction and coagulation disturbance are possible.
Toxicity
Excess colloid causes circulatory overload and pulmonary edema; stop/reduce exposure and reassess fluid and coagulation status.
Preparations
| Preparation | Form | Strength | Route |
|---|---|---|---|
| Pentastarch 10% infusion 100 mg/mL; treatment protocols are volume-based. | Injection | 100 mg / mL | IV |
Monitoring and Administration
Follow blood pressure, hydration, renal function and coagulation during treatment. Reported regimen describes a 10% pentastarch preparation; starch products are not interchangeable.
Hydroxyethyl-starch products differ in molecular size, substitution and concentration: pentastarch 200/0.5 is not the same as hetastarch or tetrastarch 130/0.4. HES class risks include coagulation impairment, hypersensitivity, volume overload and renal injury; it does not replace oxygen-carrying blood products. Assess coagulation and fluid tolerance, particularly with renal/cardiac compromise or capillary leak.