Rothe K F, Diedler J
Acta Anaesthesiol Scand. 1982 Jun;26(3):194-8. doi: 10.1111/j.1399-6576.1982.tb01752.x.
A large and important group of acid-base disturbances are the metabolic acidoses. In general, every type of metabolic acidosis can be treated with infusion of base when the underlying cause of the disturbances is removed. In our medical centers, the use of tris and bicarbonate is common. For a long time they were competitive agents and until now it was not possible to decide by available clinical methods which of these substances was more suitable for correction of metabolic acidosis. The intracellular pH of the whole rat (mean lcf-pH) was determined from the distribution of 14C labelled DMO (5,5-dimethyl-2,4-oxazolidinedione) and monitored for 6 h following intravenous application of tris or sodiumbiarbonate in a dose of 10 mmol per kg body mass. Arterial plasma pH and PCO2 were also measured. To determine and compare the effectiveness of the two buffer substances, intra- and extracellular bicarbonate were calculated from the Henderson-Hasselbalch equation. It was found that the buffering following bicarbonate infusion is more effective in both body compartments. Sodiumbicarbonate should be preferred in daily practice.
一大类重要的酸碱平衡紊乱是代谢性酸中毒。一般来说,当去除紊乱的潜在病因后,每种类型的代谢性酸中毒都可以通过输注碱来治疗。在我们的医疗中心,三羟甲基氨基甲烷(tris)和碳酸氢钠的使用很常见。长期以来,它们是相互竞争的药物,直到现在,通过现有的临床方法还无法确定哪种物质更适合纠正代谢性酸中毒。通过14C标记的二甲基异恶唑二酮(DMO,5,5 - 二甲基 - 2,4 - 恶唑烷二酮)的分布来测定整个大鼠的细胞内pH(平均lcf - pH),并在静脉注射每千克体重10 mmol的tris或碳酸氢钠后监测6小时。还测量了动脉血浆pH和PCO2。为了确定和比较这两种缓冲物质的有效性,根据亨德森 - 哈塞尔巴尔赫方程计算细胞内和细胞外的碳酸氢盐。结果发现,输注碳酸氢钠后的缓冲作用在两个身体腔室中都更有效。在日常实践中应优先选择碳酸氢钠。