Abstract
Extract: Changes in plasma osmolality as well as in extracellular fluid (ECF) space following infusion of THAM or NaHCO3 to anesthetized, nephrectomized dogs have been used to compare the osmotic effects of the two agents. Groups of five to six dogs received (per kg body weight) 10 millimoles THAM (pH 7.3), 10 millimoles THAM (pH 8.5), 5 millimoles NaHCO3, 10 millimoles NaHCO3 or 5 millimoles NaCl, while a control group of five dogs received no infusion. Increases in plasma osmolality and 36Cl space (ECF) were greater following infusion of THAM (pH 7.3 or pH 8.5) than after infusion of either NaHCO3 or NaCl. Specifically, the osmotic effects of THAM, as judged from increases in osmolality of the body fluids and in 36Cl space, were much greater than those of a 5-millimole dose of NaHCO3, which produced an equivalent rise in plasma bicarbonate, and were even greater than those of an equimolar dose of NaHCO3 (10 millimoles/kg). Furthermore, the increase in concentration of plasma bicarbonate produced by this dose of NaHCO3 was much greater than that produced by THAM. Although theoretical considerations have predicted that the osmotic effects of THAM would be as great or greater than those of NaHCO3, this is the first experimental documentation.
Speculation: The results reported herein provide further evidence for the view that THAM is not superior to NaHCO3 for treatment of clinical acid-base disturbances.
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Heird, W., Dell, R., Price, T. et al. Osmotic Effects of Infusion of THAM. Pediatr Res 6, 495–503 (1972). https://doi.org/10.1203/00006450-197205000-00003
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DOI: https://doi.org/10.1203/00006450-197205000-00003