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Effects of Tromethamine and Sodium Bicarbonate Buffers During Cardiac Resuscitation
Author(s) -
Planta Martin,
Gudipati Chalipathirao,
Weil Max Harry,
Kraus Louis J.,
Rackow Eric C.
Publication year - 1988
Publication title -
the journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.92
H-Index - 116
eISSN - 1552-4604
pISSN - 0091-2700
DOI - 10.1002/j.1552-4604.1988.tb03182.x
Subject(s) - sodium bicarbonate , anesthesia , bicarbonate , medicine , resuscitation , pharmacology , chemistry
The effects on cardiac resuscitability of iso‐osmolal solutions of tris‐hydroxymethyl‐aminomethane (tromethamine), sodium bicarbonate (NaHCO 3 ) and sodium chloride placebo were compared in 30 domestic pigs using a well‐established model of electrically induced cardiac arrest and resuscitation. We hypothesized that a carbon dioxide (CO 2 ) consuming buffer like tromethamine would reduce and sodium bicarbonate would increase the respiratory acidosis of mixed venous blood, which had recently been demonstrated in our laboratory. Tromethamine did decrease and sodium bicarbonate did increase both arterial and mixed venous CO 2 during cardiopulmonary resuscitation (CPR). Both concentrations of end‐tidal CO 2 and coronary venous Pco 2 were significantly lower after tromethamine than after bicarbonate. However, tromethamine produced an unexpected vasodilator effect with reduction of mean aortic and coronary perfusion pressures to levels that are known to reduce resuscitability and survival independently of its buffer action. Neither resuscitability nor survival was altered by bicarbonate therapy in comparison with sodium chloride placebo.