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Anesth Analg 1977; 56:38-45
© 1977 International Anesthesia Research Society
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Comparison of THAM and Sodium Bicarbonate in Resuscitation of the Heart After Ventricular Fibrillation in Dogs

M. MINUCK, MD*, and G. P. SHARMA, MD{dagger}

*Professor, Department of Anesthesia, University of Manitoba; Head, Department of Anaesthesia, St. Boniface General Hospital., R. O. Burrell Surgical Research Laboratory, St. Boniface General Hospital, Winnipeg, Manitoba, Canada R2H 2A6. {dagger}Director, R. O. Burrell Surgical Research Laboratory., R. O. Burrell Surgical Research Laboratory, St. Boniface General Hospital, Winnipeg, Manitoba, Canada R2H 2A6.

Abstract

Tris (hydroxymethyl) aminomethane (trometh-amine or THAM) has been suggested as an effective substitute for sodium bicarbonate (NaHCO3) in the treatment of metabolic acidosis accompanying cardiac arrest. Even though several reports on its appraisal have been published, there is still no clear agreement on its therapeutic value. A double-blind study was therefore undertaken to compare in 36 dogs the effectiveness of 0.6 M THAM, 0.3 M THAM, and NaHCO3 (0.892 mEq/ml) to correct metabolic acidosis produced during 3 minutes of cardiac fibrillation, followed by a 3-minute period of cardiac compression. The dogs were then defibrillated and observed for 45 minutes. One group of 8 dogs was treated with 0.9 percent NaCl infusion.

Compared with 0.9 percent NaCl, both THAM and NaHCO3 were equally effective in correcting metabolic acidosis (p<0.05). Initially, 0.6 M THAM produced a more pronounced (p<0.05) elevation of blood pH, but this effect was not sustained during the later post defibrillation period. There was little difference in the effect of either of these drugs on mean aortic pressure and total peripheral vascular resistance. It is concluded that adequate ventilation and effective cardiac compression are still the chief criteria on which the final outcome of cardiac resuscitation depends. Correction of metabolic acidosis is important supportive therapy, but either THAM or NaHCO3 can be used with comparatively equivalent effect.




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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 1977 by the International Anesthesia Research Society.