Resuscitation
Volume 37, Issue 3 , Pages 161-171 , June 1998

Alkaline buffers for correction of metabolic acidosis during cardiopulmonary resuscitation with focus on Tribonat®—A review

Received 18 January 1998 ,Revised 25 March 1998 ,Accepted 2 April 1998.

References 

  1. von Planta M, Bar-Joseph G, Wiklund L, et al.  Pathophysiologic and therapeutic implications of acid–base changes during CPR. Ann Emerg Med. 1993;22:404–410
  2. American Heart Association. Standards and guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiac care (ECC). J Am Med Assoc 1986;255:2905–2989.
  3. American Heart Association. Guidelines for cardiopulmonary resuscitation and emergency cardiac care. J Am Med Assoc 1992;268:2171–2295.
  4. Basic Life Support Working Party of the European Resuscitation Council. Guidelines for basic life support. Resuscitation 1992;24:103–110.
  5. Advanced Life Support Working Party of the European Resuscitation Council. Guidelines for advanced life support. Resuscitation 1992;24:111–121.
  6. Grillo JA, Gonzalez ER. Changes in the pharmacotherapy of CPR. Heart Lung. 1993;22:548–553
  7. Brown C, Wiklund L, Bar-Joseph G, et al.  Future directions for resuscitation research. IV. Innovative advanced life support pharmacology. Resuscitation. 1996;33:163–177
  8. Ostrea EM, Odell GB. The influence of bicarbonate administration on blood pH in a `closed system': Clinical implications. J Pediatr. 1972;80:671–680
  9. Bishop RL, Weisfeldt ML. Sodium bicarbonate administration during cardiac arrest. Effect on arterial pH, Pco2, and osmolality. J Am Med Assoc. 1976;235:506–509
  10. Steichen JJ, Kleinman LI. Studies in acid–base balance. I. Effect of alkali therapy in newborn dogs with mechanically fixed ventilation. J Pediatr. 1977;91:287–291
  11. Arieff AI, Leach W, Park R, et al.  Systemic effects of NaHCO3 in experimental lactic acidosis in dogs. Am J Physiol. 1982;242:F586–F591
  12. Kindig NB, Filley GF. Intravenous bicarbonate may cause transient intracellular acidosis. Chest. 1983;83:712
  13. Graf H, Leach W, Arieff AI. Metabolic effects of sodium bicarbonate in hypoxic lactic acidosis in dogs. Am J Physiol. 1985;249:F630–F635
  14. Graf H, Arieff AI. The use of sodium bicarbonate in the therapy of organic acidosis. Intensive Care Med. 1986;12:285–288
  15. Stacpoole PW. Lactic acidosis: The case against bicarbonate therapy. Ann Intern Med. 1986;105:276–279
  16. Ritter JM, Doktor HS, Benjamin N. Paradoxical effect of bicarbonate on cytoplasmic pH. Lancet. 1990;335:1243–1246
  17. Nahas GG. The pharmacology of tris(hydroxymethyl)aminomethane (THAM). Pharmacol Rev. 1962;14:447–472
  18. Filley GF, Kindig NB. Carbicarb, an alkalinizing ion-generating agent of possible clinical usefulness. Trans Am Clin Climatol Assoc. 1984;96:141–153
  19. Wiklund L, Öquist L, Skoog G, et al.  Clinical buffering of metabolic acidosis: Problems and a solution. Resuscitation. 1985;12:279–293
  20. Wiklund L, Sahlin K. Induction and treatment of metabolic acidosis: A study of pH changes in porcine skeletal muscle and cerebrospinal fluid. Crit Care Med. 1985;13:109–113
  21. Wiklund L, Söderberg D, Henneberg S, et al.  Kinetics of carbon dioxide during cardiopulmonary resuscitation. Crit Care Med. 1986;14:1015–1022
  22. Wiklund L, Ronquist G, Stiernström H, et al.  Effects of alkaline buffer administration on survival and myocardial energy metabolism in pigs subjected to ventricular fibrillation and closed chest CPR. Acta Anaesthesiol Scand. 1990;34:430–439
  23. Wiklund L, Jorfeldt L, Stiernström H, et al.  Gas exchange as monitored in mixed venous and arterial blood during experimental cardiopulmonary resuscitation. Acta Anaesthesiol Scand. 1992;36:427–435
  24. Bjerneroth G, Sammeli O, Li Y-C, et al.  Effects of alkaline buffers on cytoplasmic pH in lymphocytes. Crit Care Med. 1994;22:1550–1556
  25. Dybvik T, Strand T, Steen PA. Buffer therapy during out-of-hospital cardiopulmonary resuscitation. Resuscitation. 1995;29:89–95
  26. Li Y-C, Wiklund L, Tarkkila P, et al.  Influence of alkaline buffers on cytoplasmic pH in myocardial cells exposed to metabolic acidosis. Resuscitation. 1996;32:33–44
  27. Li Y-C, Wiklund L, Bjerneroth G. Influence of alkaline buffers on cytoplasmic pH in myocardial cells exposed to hypoxia. Resuscitation. 1997;34:71–77
  28. Weil MH, Afifi AA. Experimental and clinical studies on lactate and pyruvate as indicators of the severity of acute circulatory failure (shock). Circulation. 1970;41:989–1001
  29. Opie LH. Effects of regional ischemia on metabolism of glucose and fatty acids. Circ Res. 1976;38(Suppl I):52–74
  30. Weil MH, Gazmuri RJ, Rackow EC. The clinical rationale of cardiac resuscitation. Dis Mon. 1990;36:421–468
  31. Gudipati CV, Weil MH, Bisera J, et al.  Expired carbon dioxide: a noninvasive monitor of cardiopulmonary resuscitation. Circulation. 1988;77:234–239
  32. von Planta M, Weil MH, Gazmuri RJ, et al.  Myocardial acidosis associated with CO2 production during cardiac arrest and resuscitation. Circulation. 1989;80:684–692
  33. Trevino RP, Bisera J, Weil MH, et al.  End-tidal CO2 as a guide to successful cardiopulmonary resuscitation: A preliminary report. Crit Care Med. 1985;13:910–911
  34. Grundler W, Weil MH, Rackow EC. Arteriovenous carbon dioxide and pH gradients during cardiac arrest. Circulation. 1986;74:1071–1074
  35. Weil MH, Rackow EC, Trevino R, et al.  Difference in acid–base state between venous and arterial blood during cardiopulmonary resuscitation. New Engl J Med. 1986;315:153–156
  36. Koster R, Carli P. Acid–base management. A statement for the Advanced Life Support Working Party of the European Resuscitation Council. Resuscitation. 1992;24:143–146
  37. Falk JL, Rackow EC, Weil MH. End-tidal carbon dioxide concentration during cardiopulmonary resuscitation. New Engl J Med. 1988;318:607–611
  38. Gazmuri RJ, von Planta M, Weil MH, et al.  Arterial Pco2 as an indicator of systemic perfusion during cardiopulmonary resuscitation. Crit Care Med. 1989;17:237–240
  39. Wallace WM, Hastings AB. The distribution of the bicarbonate ion in mammalian muscle. J Biol Chem. 1942;144:637–649
  40. Landow L, Visner MS. Does NaHCO3 exacerbate myocardial acidosis?. J Cardiothorac Vasc Anesth. 1993;7:340–351
  41. Cohen RD, Simpson R. Lactate metabolism. Anesthesiology. 1975;43:661–673
  42. Jerusalem E, Starling EH. On the significance of carbon dioxide for the heart beat. J Physiol. 1910;40:279–294
  43. McElroy WT, Gerdes AJ, Brown EB. Effects of CO2, bicarbonate and pH on the performance of isolated perfused guinea pig hearts. Am J Physiol. 1958;195:412–416
  44. Wildenthal K, Mierzwiak DS, Myers RW, et al.  Effects of acute lactic acidosis on left ventricular performance. Am J Physiol. 1968;214:1352–1359
  45. Cingolani HE, Faulkner SL, Mattiazzi AR, et al.  Depression of human myocardial contractility with `respiratory' and `metabolic' acidosis. Surgery. 1975;77:427–432
  46. Weisfeldt ML, Bishop RL, Greene HL. Effects of pH and Pco2 on performance of ischemic myocardium. In: Roy PE, Rona G, editors. Recent Advances in Studies on Cardiac Structure and Metabolism. Baltimore: University Park Press, 1975;10:355–364.
  47. Kleber AG. Extracellular potassium accumulation in acute myocardial ischemia. J Mol Cell Cardiol. 1984;16:389–394
  48. Allen DG, Orchard CH. Myocardial contractile function during ischemia and hypoxia. Circ Res. 1987;60:153–168
  49. Orchard CH, Kentish JC. Effects of changes of pH on the contractile function of cardiac muscle. Am J Physiol. 1990;258:C967–C981
  50. Yudkin J, Cohen RD, Slack B. The haemodynamic effects of metabolic acidosis in the rat. Clin Sci Mol Med. 1976;50:177–184
  51. Williamson JR, Safer B, Rich T, et al.  Effects of acidosis on myocardial contractility and metabolism. Acta Med Scand Suppl. 1976;587:95–112
  52. Steenbergen C, Deleeuw G, Rich T, et al.  Effects of acidosis and ischemia on contractility and intracellular pH of rat heart. Circ Res. 1977;41:849–858
  53. Poole-Wilson PA, Langer GA. Effects of acidosis on mechanical function and Ca2+ exchange in rabbit myocardium. Am J Physiol. 1979;236:H525–H533
  54. Fry CH, Poole-Wilson PA. Effects of acid–base changes on excitation–contraction coupling in guinea-pig and rabbit cardiac ventricular muscle. J Physiol. 1981;313:141–160
  55. MacGregor DC, Wilson GJ, Holness DE, et al.  Intramyocardial carbon dioxide tension: a guide to the safe period of anoxic arrest of the heart. J Thorac Cardiovasc Surg. 1974;68:101–107
  56. Downing SE, Talner NS, Gardner TH. Influences of arterial oxygen tension and pH on cardiac function in the newborn lamb. Am J Physiol. 1966;211:1203–1208
  57. Donaldson SKB, Hermansen L. Differential, direct effects of H+ on Ca2+-activated force of skinned fibers from the soleus, cardiac and adductor magnus muscles of rabbits. Pflügers Arch. 1978;376:55–65
  58. Allen DG, Orchard CH. Intracellular calcium concentration during hypoxia and metabolic inhibition in mammalian ventricular muscle. J Physiol. 1983;339:107–122
  59. Blanchard EM, Solaro RJ. Inhibition of the activation and troponin calcium binding of dog cardiac myofibrils by acidic pH. Circ Res. 1984;55:382–391
  60. Orchard CH, Hamilton DL, Astles P, et al.  The effect of acidosis on the relationship between Ca2+ and force in isolated ferret cardiac muscle. J Physiol. 1991;436:559–578
  61. Ellis D, Thomas RC. Direct measurement of the intracellular pH of mammalian cardiac muscle. J Physiol. 1976;262:755–771
  62. Williamson JR, Schaffer SW, Ford C. Contribution of tissue acidosis to ischemic injury in the perfused rat heart. Circulation. 1976;53(Suppl I):3–14
  63. Jacobus WE, Pores IH, Lucas SK et al. The role of intracellular pH in the control of normal and ischemic myocardial contractility: A 31P nuclear magnetic resonance and mass spectrometry study. In: Nuccitelli R, Deamer DW, editors. Intracellular pH: Its Measurement, Regulation and Utilization in Cellular Functions. New York: Alan R. Liss, 1982;537–565.
  64. Darby TD. Effects of 2-amino-2-hydroxymethyl-1,3-propanediol during shock and catecholamine administration. Ann New York Acad Sci. 1961;92:674–686
  65. Davies AO. Rapid desensitization and uncoupling of human beta-adrenergic receptors in an in vitro model of lactic acidosis. J Clin Endocrinol Metab. 1984;59:398–405
  66. Carafoli E. The homeostasis of calcium in heart cells. J Mol Cell Cardiol. 1985;17:203–212
  67. Tyberg JV, Yeatman LA, Parmley WW, et al.  Effects of hypoxia on mechanics of cardiac contraction. Am J Physiol. 1970;218:1780–1788
  68. Apstein CS, Deckelbaum L, Hagopian L, et al.  Acute cardiac ischemia and reperfusion: contractility, relaxation and glycolysis. Am J Physiol. 1978;235:H637–H648
  69. Nayler WG, Poole-Wilson PA, Williams A. Hypoxia and calcium. J Mol Cell Cardiol. 1979;11:683–706
  70. Poole-Wilson PA, Harding DP, Bourdillon PDV, et al.  Calcium out of control. J Mol Cell Cardiol. 1984;16:175–187
  71. Kohmoto O, Spitzer KW, Movsesian MA, et al.  Effects of intracellular acidosis on [Ca2+]i transients, transsarcolemmal Ca2+ fluxes, and contraction in ventricular myocytes. Circ Res. 1990;66:622–632
  72. Opie LH, du Toit EF. Postischemic stunning: the two-phase model for the role of calcium as pathogen. J Cardiovasc Pharmacol. 1992;20:S1–S4
  73. Farber JL. Biology of disease. Membrane injury and calcium homeostasis in the pathogenesis of coagulative necrosis. Lab Invest. 1982;47:114–123
  74. Steenbergen C, Murphy E, Watts JA, et al.  Correlation between cytosolic free calcium, contracture, ATP, and irreversible ischemic injury in perfused rat heart. Circ Res. 1990;66:135–146
  75. Vaughan-Jones RD, Lederer WJ, Eisner DA. Ca2+ ions can affect intracellular pH in mammalian cardiac muscle. Nature. 1983;301:522–524
  76. Ng ML, Levy MN, Zieske HA. Effects of changes of pH and of carbon dioxide tension on left ventricular performance. Am J Physiol. 1967;213:115–120
  77. Barry WH, Bridge JHB. Intracellular calcium homeostasis in cardiac myocytes. Circulation. 1993;87:1806–1815
  78. Anderson SE, Murphy E, Steenbergen C, et al.  Na–H exchange in myocardium: effects of hypoxia and acidification on Na and Ca. Am J Physiol. 1990;259:C940–C948
  79. Tani M, Neely JR. Na+ accumulation increases Ca2+ overload and impairs function in anoxic rat heart. J Mol Cell Cardiol. 1990;22:57–72
  80. Tani M. Mechanisms of Ca2+ overload in reperfused ischemic myocardium. Annu Rev Physiol. 1990;52:543–549
  81. Haigney MCP, Miyata H, Lakatta EG, et al.  Dependence of hypoxic cellular calcium loading on Na+–Ca2+ exchange. Circ Res. 1992;71:547–557
  82. Lynch C. Calcium metabolism in the normal and diseased heart. Curr Opin Anaesthesiol. 1994;7:5–11
  83. Cairns SP, Westerblad H, Allen DG. Changes in myoplasmic pH and calcium concentration during exposure to lactate in isolated rat ventricular myocytes. J Physiol. 1993;464:561–574
  84. Kihara Y, Morgan JP. Intracellular calcium and ventricular fibrillation. Studies in the aequorin-loaded isovolumetric ferret heart. Circ Res. 1991;68:1378–1389
  85. Neubauer S, Newell JB, Ingwall JS. Metabolic consequences and predictability of ventricular fibrillation in hypoxia. A 31P- and 23Na-nuclear magnetic resonance study of the isolated heart. Circulation. 1992;86:302–310
  86. Clancy RL, Cingolani HE, Taylor RR, et al.  Influence of sodium bicarbonate on myocardial performance. Am J Physiol. 1967;212:917–923
  87. Graf H, Leach W, Arieff AI. Evidence for a detrimental effect of bicarbonate therapy in hypoxic lactic acidosis. Science. 1985;227:754–756
  88. Jacobs MH. To what extent are the physiological effects of carbon dioxide due to hydrogen ions?. Am J Physiol. 1920;51:321–331
  89. Kette F, Weil MH, Gazmuri RJ, et al.  Intramyocardial hypercarbic acidosis during cardiac arrest and resuscitation. Crit Care Med. 1993;21:901–906
  90. Sanders AB, Ewy GA, Taft TV. Prognostic and therapeutic importance of the aortic diastolic pressure in resuscitation from cardiac arrest. Crit Care Med. 1984;12:871–873
  91. Guerci AD, Chandra N, Johnson E, et al.  Failure of sodium bicarbonate to improve resuscitation from ventricular fibrillation in dogs. Circulation. 1986;74(Suppl IV):75–79
  92. Paradis NA, Martin GB, Rivers EP, et al.  Coronary perfusion pressure and the return of spontaneous circulation in human cardiopulmonary resuscitation. J Am Med Assoc. 1990;263:1106–1113
  93. Kette F, Weil MH, Gazmuri RJ. Buffer solutions may compromise cardiac resuscitation by reducing coronary perfusion pressure. J Am Med Assoc. 1991;266:2121–2126
  94. Read RC, Johnson JA, Vick JA, et al.  Vascular effects of hypertonic solutions. Circ Res. 1960;8:538–548
  95. Coté CJ, Greenhow DE, Marshall BE. The hypotensive response to rapid intravenous administration of hypertonic solutions in man and in the rabbit. Anesthesiology. 1979;50:30–35
  96. Agarwal JB, Baile EM, Palmer WH. Reflex systemic hypotension due to hypertonic solutions in pulmonary circulation. J Appl Physiol. 1969;27:251–255
  97. Huseby JS, Gumprecht DG. Hemodynamic effects of rapid bolus hypertonic sodium bicarbonate. Chest. 1981;79:552–554
  98. Holmdahl MH, Nahas GG, Hassam D, et al.  Acid–base changes in the cerebrospinal fluid following rapid changes in the bicarbonate/carbonic acid ratio in the blood. Ann New York Acad Sci. 1961;92:520–527
  99. Duthie SE, Goulin GD, Zornow MH, et al.  Effects of THAM and sodium bicarbonate on intracranial pressure and mean arterial pressure in an animal model of focal cerebral injury. J Neurosurg Anesthesiology. 1994;6:201–208
  100. Bureau MA, Bégin R, Berthiaume Y, et al.  Cerebral hypoxia from bicarbonate infusion in diabetic acidosis. J Pediatr. 1980;96:968–973
  101. White BC, Winegar CP, Henderson O, et al.  Prolonged hypoperfusion in the cerebral cortex following cardiac arrest and resuscitation in dogs. Ann Emerg Med. 1983;12:414–417
  102. Berenyi KJ, Wolk M, Killip T. Cerebrospinal fluid acidosis complicating therapy of experimental cardiopulmonary arrest. Circulation. 1975;52:319–324
  103. Kucera RR, Shapiro JI, Whalen MA, et al.  Brain pH effects of NaHCO3 and Carbicarb in lactic acidosis. Crit Care Med. 1989;17:1320–1323
  104. Mattar JA, Weil MH, Shubin H, et al.  Cardiac arrest in the critically ill. II. Hyperosmolal states following cardiac arrest. Am J Med. 1974;56:162–168
  105. Simmons MA, Adcock EW, Bard H, et al.  Hypernatremia and intracranial hemorrhage in neonates. New Engl J Med. 1974;291:6–10
  106. Thomas DB. Hyperosmolality and intraventricular haemorrhage in premature babies. Acta Paediatr Scand. 1976;65:429–432
  107. Bellingham AJ, Detter JC, Lenfant C. Regulatory mechanisms of hemoglobin oxygen affinity in acidosis and alkalosis. J Clin Invest. 1971;50:700–706
  108. Ditzel J, Standl E. The oxygen transport system of red blood cells during diabetic ketoacidosis and recovery. Diabetologia. 1975;11:255–260
  109. Knochel JP. The pathophysiology and clinical characteristics of severe hypophosphatemia. Arch Intern Med. 1977;137:203–220
  110. Lang RM, Fellner SK, Neumann A, et al.  Left ventricular contractility varies directly with blood ionized calcium. Ann Intern Med. 1988;108:524–529
  111. Oliva PB. Lactic acidosis. Am J Med. 1970;48:209–225
  112. Fraley DS, Adler S, Bruns FJ, et al.  Stimulation of lactate production by administration of bicarbonate in a patient with a solid neoplasm and lactic acidosis. New Engl J Med. 1980;303:1100–1102
  113. Hale PJ, Crase J, Nattrass M. Metabolic effects of bicarbonate in the treatment of diabetic ketoacidosis. Br Med J. 1984;289:1035–1038
  114. Lawson NW, Butler GH, Ray CT. Alkalosis and cardiac arrhythmias. Anesth Analg. 1973;52:951–964
  115. Lever E, Jaspan JB. Sodium bicarbonate therapy in severe diabetic ketoacidosis. Am J Med. 1983;75:263–268
  116. Gomori G. Buffers in the range of pH 6.5 to 9.6. Proc Soc Exp Biol New York. 1946;62:33–34
  117. Strauss J. Tris (hydroxymethyl) amino-methane (THAM): A pediatric evaluation. Pediatrics. 1968;41:667–689
  118. Nahas GG. The clinical pharmacology of THAM [tris(hydroxymethyl)aminomethane]. Clin Pharmacol Ther. 1963;4:784–803
  119. Ligou JC, Nahas GG. Comparative effects of acidosis induced by acid infusion and CO2 accumulation. Am J Physiol. 1960;198:1201–1206
  120. Omachi A, Macey RI, Waldeck JG. Permeability of cell membranes to amine buffers and their effects on electrolyte transport. Ann New York Acad Sci. 1961;92:478–485
  121. Holmdahl MH, Nahas GG. Volume of distribution of C14-labeled tris(hydroxymethyl)aminomethane. Am J Physiol. 1962;202:1011–1014
  122. Conant JS, Hughes RE. The usefulness of THAM in metabolic acidosis. Ann New York Acad Sci. 1961;92:751–754
  123. Kaplan SA. Tris (hydroxymethyl) aminomethane (THAM)—a new buffer for therapeutic use. Am J Dis Child. 1962;103:33–35
  124. Kaplan S, Fox RP, Clark LC. Amine buffers in the management of acidosis. Am J Dis Child. 1962;103:4–9
  125. Srouji MN, Trusler GA, Zingg W. Influence of THAM on survival in metabolic acidosis due to hypoperfusion. J Pediatr Surg. 1967;2:44–54
  126. Wang H, Katz RL. Effects of changes in coronary blood pH on the heart. Circ Res. 1965;17:114–122
  127. Cline RE, Wallace AG, Sealy WC, et al.  Antiarrhythmic properties of tris (hydroxymethyl) aminomethane. Am J Cardiol. 1968;21:38–43
  128. Clark LC. The use of amine buffers in cardiovascular surgery. Ann New York Acad Sci. 1961;92:687–703
  129. Ligou JC, Le Tallec Y, Bernadet P, et al.  Effects of 2-amino-2-hydroxymethyl-1,3-propanediol on the pulmonary hypertension of hypercapnic acidosis. Ann New York Acad Sci. 1961;92:617–626
  130. Effron MB, Guarnieri T, Frederiksen JW, et al.  Effect of tris(hydroxymethyl)aminomethane on ischemic myocardium. Am J Physiol. 1978;235:H167–H174
  131. Peirce EC. Effects of 2-amino-1-hydroxymethyl-1,3-propanediol (tris) during cardiac bypass procedures. Ann New York Acad Sci. 1961;92:765–782
  132. Lee WH, Darby TD, Aldinger EE, et al.  Use of THAM in the management of refractory cardiac arrest. Am Surg. 1962;28:87–89
  133. Wolf AL, Levi L, Marmarou A, et al.  Effect of THAM upon outcome in severe head injury: a randomized prospective clinical trial. J Neurosurg. 1993;78:54–59
  134. Tarail R, Bennett TE. Hypoglycemic activity of tris buffer in man and dog. Proc Soc Exp Biol Med. 1959;102:208–209
  135. Buse MG, Buse J, McMaster J, et al.  The effect of tris (hydroxymethyl) aminomethane on glucose utilization of skeletal muscle. Metabolism. 1964;13:339–353
  136. Triner I, Kypson J, Zicha B. Effect of THAM on carbohydrate metabolism. Ann Anesth Franç. 1966;7:593–596
  137. Swanson AG. Potential harmful effects of treating pulmonary encephalopathy with a carbon dioxide buffering agent. Am J Med Sci. 1960;240:433–437
  138. Aber GM, Bayley TJ, Bishop JM. The effect of THAM infusion on simultaneously studied cardiac, respiratory and renal function in patients with obstructive airways disease. Clin Sci. 1963;25:171–180
  139. Nahas GG, Fink BR, Ploski WS, et al.  The depressant effects of tris(hydroxymethyl)-aminomethane and of mannitol on respiration. Ann New York Acad Sci. 1963;109:783–803
  140. Brinkman GL, Remp DG, Coates EO, et al.  The treatment of respiratory acidosis with THAM. Am J Med Sci. 1960;239:341–346
  141. Luchsinger PC. The use of 2-amino-2 hydroxymethyl-1,3-propanediol in the management of respiratory acidosis. Ann New York Acad Sci. 1961;92:743–750
  142. Darby TD, Anderson SJ. Tolerance and toxicity of THAM. Ann Anesth Franç. 1966;7:585–592
  143. Bleich HL, Schwartz WB. Tris buffer (THAM). An appraisal of its physiologic effects and clinical usefulness. New Engl J Med. 1966;274:782–787
  144. Brinkman GL, Brunswick WL, Whitehouse FW. The use of 2-amino-2-hydroxymethyl-1,3-propanediol in the correction of metabolic and respiratory acidosis. Ann New York Acad Sci. 1961;92:735–742
  145. Roberts M, Linn S. Acute and subchronic toxicity of 2-amino-2-hydroxymethyl-1,3-propanediol. Ann New York Acad Sci. 1961;92:724–734
  146. von Planta M, Gudipati C, Weil MH, et al.  Effects of tromethamine and sodium bicarbonate buffers during cardiac resuscitation. J Clin Pharmacol. 1988;28:594–599
  147. Sun JH, Filley GF, Hord K, et al.  Carbicarb: An effective substitute for NaHCO3 for the treatment of acidosis. Surgery. 1987;102:835–839
  148. Bersin RM, Arieff AI. Improved hemodynamic function during hypoxia with carbicarb, a new agent for the management of acidosis. Circulation. 1988;77:227–233
  149. Kindig NB, Sherill DS, Shapiro JI, et al.  Extracorporeal bicarbonate space after bicarbonate or a bicarbonate–carbonate mixture in acidotic dogs. J Appl Physiol. 1989;67:2331–2334
  150. Rhee KH, Toro LO, McDonald GG, et al.  Carbicarb, sodium bicarbonate, and sodium chloride in hypoxic lactic acidosis. Effect on arterial blood gases, lactate concentrations, hemodynamic variables, and myocardial intracellular pH. Chest. 1993;104:913–918
  151. Kamel KS. Does the administration of carbicarb lead acutely to back-titration of non-bicarbonate buffers?. Clin Nephrol. 1996;46:112–116
  152. Shapiro JI. Functional and metabolic responses of isolated hearts to acidosis: effects of sodium bicarbonate and Carbicarb. Am J Physiol. 1990;258:H1835–H1839
  153. Shapiro JI, Whalen M, Kucera R, et al.  Brain pH responses to sodium bicarbonate and Carbicarb during systemic acidosis. Am J Physiol. 1989;256:H1316–H1321
  154. Shapiro JI. Pathogenesis of cardiac dysfunction during metabolic acidosis: therapeutic implications. Kidney Int Suppl. 1997;61:S47–S51
  155. Kucera R, Whalen M, Shapiro JI. Electroencephalographic consequences of alkalinization therapy during lactic acidosis: Different effects of sodium bicarbonate and Carbicarb. J Crit Care. 1991;6:71–74
  156. Sun S, Weil MH, Tang W, et al.  Effects of buffer agents on postresuscitation myocardial dysfunction. Crit Care Med. 1996;24:2035–2041
  157. Kette F, Weil MH, von Planta M, et al.  Buffer agents do not reverse intramyocardial acidosis during cardiac resuscitation. Circulation. 1990;81:1660–1666
  158. Gazmuri RJ, von Planta M, Weil MH, et al.  Cardiac effects of carbon dioxide-consuming and carbon dioxide-generating buffers during cardiopulmonary resuscitation. J Am Coll Cardiol. 1990;15:482–490
  159. Basir MA, Bhatia J, Brudno DS, et al.  Effects of Carbicarb and sodium bicarbonate on hypoxic lactic acidosis in newborn pigs. J Invest Med. 1996;44:70–74
  160. Beech JS, Williams SC, Iles RA, et al.  Haemodynamic and metabolic effects in diabetic ketoacidosis in rats of treatment with sodium bicarbonate or a mixture of sodium bicarbonate and sodium carbonate. Diabetologia. 1995;38:889–898
  161. Benjamin E, Oropello JM, Abalos AM, et al.  Effects of acid–base correction on hemodynamics, oxygen dynamics, and resuscitability in severe canine hemorrhagic shock. Crit Care Med. 1994;22:1616–1623
  162. Kollöffel WJ, de Vroom TE, Weekers LEA, et al.  Severe cutaneous side effects of peripheral infusions with carbicarb half strength. Intensive Care Med. 1994;20:531
  163. Gedeborg R, Wiklund L. The biological activity of adrenaline after injection through an intravenous cannula containing alkaline buffer. Resuscitation. 1989;18:49–58
  164. Rubertsson S, Wiklund L. Hemodynamic effects of epinephrine in combination with different alkaline buffers during experimental, open-chest, cardiopulmonary resuscitation. Crit Care Med. 1993;21:1051–1057
  165. Herlitz J, Ekström L, Wennerblom B, et al.  Predictors of early and late survival after out-of-hospital cardiac arrest in which asystole was the first recorded arrhythmia on scene. Resuscitation. 1994;28:27–36
  166. Herlitz J, Ekström L, Wennerblom B, et al.  Survival among patients with out-of-hospital cardiac arrest found in electromechanical dissociation. Resuscitation. 1995;29:97–106
  167. Koster RW. Correction of acidosis during cardio-pulmonary resuscitation. Editorial. Resuscitation. 1995;29:87–88
  168. Bjerneroth G, Li Y-C, Wiklund L, et al.  Effect of tris buffer on free cytosolic calcium in myocardial cells. Crit Care Med. 1996;24:1713–1718
  169. Wiklund L, Ronquist G, Roomans GM, et al.  Response of myocardial cellular energy metabolism to variation of buffer composition during open-chest experimental cardiopulmonary resuscitation in the pig. Eur J Clin Invest. 1997;27:417–426
  170. Gaul GB, Gruska M, Titscher G, et al.  Prediction of survival after out-of-hospital cardiac arrest: results of a community-based study in Vienna. Resuscitation. 1996;32:169–176

PII: S0300-9572(98)00051-3

Resuscitation
Volume 37, Issue 3 , Pages 161-171 , June 1998

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