持续输注三（羟甲基）氨基甲烷对酸中毒、氧亲和力和血清渗透压的影响。

Effects of a continuous infusion of tris(hydroxymethyl)aminomethane on acidosis, oxygen affinity, and serum osmolality.

作者信息

Schneiderman R, Rosenkrantz T S, Knox I, Cramer R, Smoloski R, Raye J R

机构信息

Department of Pediatrics, University of Connecticut Health Center, Farmington 06030.

出版信息

Biol Neonate. 1993;64(5):287-94. doi: 10.1159/000244001.

DOI:10.1159/000244001

PMID:8297938

Abstract

The effects of a continuous infusion of tris(hydroxymethyl)aminomethane (THAM) on pH, base excess, p50, serum osmolality, and plasma drug concentration during respiratory acidosis were studied in newborn piglets. Measurements were made during three experimental periods: (1) control period with normal blood gases; (2) hypercapnia period, and (3) hypercapnia plus THAM period (THAM infusion: 1.65 mmol/kg/h). pH decreased and paCO2 increased between control period (7.40 +/- 0.05 and 45 +/- 3 mm Hg) and hypercapnia period (7.24 +/- 0.06 and 59 +/- 2 mm Hg; p < 0.001; mean +/- SD). pH returned to baseline (7.37 +/- 0.04) during the hypercapnia plus THAM period, while paCO2 remained elevated (63 +/- 4 mm Hg). p50 increased from 30.7 +/- 5.9 to 38.3 +/- 4.7 (p < 0.05) during hypercapnia and decreased with hypercapnia plus THAM. THAM concentration and base excess increased with time and were linearly related. Serum osmolality was unchanged during the THAM infusion. We conclude that continuous infusion of THAM is effective in normalizing pH during respiratory acidosis in the piglet.

摘要

在新生仔猪中研究了持续输注三羟甲基氨基甲烷（THAM）对呼吸性酸中毒期间pH值、碱剩余、P50、血清渗透压和血浆药物浓度的影响。在三个实验阶段进行了测量：（1）血气正常的对照期；（2）高碳酸血症期；（3）高碳酸血症加THAM期（THAM输注：1.65 mmol/kg/h）。在对照期（7.40±0.05和45±3 mmHg）和高碳酸血症期（7.24±0.06和59±2 mmHg；p<0.001；平均值±标准差）之间，pH值下降，PaCO2升高。在高碳酸血症加THAM期，pH值恢复到基线水平（7.37±0.04），而PaCO2仍保持升高（63±4 mmHg）。在高碳酸血症期间，P50从30.7±5.9增加到38.3±4.7（p<0.05），在高碳酸血症加THAM时降低。THAM浓度和碱剩余随时间增加且呈线性相关。在THAM输注期间，血清渗透压未发生变化。我们得出结论，持续输注THAM可有效使仔猪呼吸性酸中毒期间的pH值恢复正常。