Waters J H, Howard R S, Lesnik I K
Department of Anesthesiology, Naval Medical Center, San Diego, California 92134-5000, USA.
Anesth Analg. 1996 Oct;83(4):789-92. doi: 10.1097/00000539-199610000-00023.
The purpose of this study was to evaluate the plasma potassium (K+) response after administration of tromethamine (THAM) or sodium bicarbonate (NaHCO3) in an acidotic rabbit model. Eighteen healthy, adult female New Zealand White rabbits were subjected to severe hypoxia until a base deficit of -10 mEq/L resulted. Rabbits were then randomized to receive THAM solution, NaHCO3, or no drug (control). The drug was administered over 2 min in quantities calculated to correct a base deficit of 10 or greater. Plasma K+ and sodium (Na+) were measured for 45 min after drug administration. No difference in K+ response was noted after THAM, NaHCO3, or no drug. In contrast, THAM resulted in significantly lower Na+ concentrations when compared to the NaHCO3 or the control group (P < 0.05). In this rabbit model, alkalinization after THAM administration results in K+ changes similar to those after NaHCO3. THAM should be considered when treating acidosis in patients where hypernatremia is a concern.
本研究的目的是在酸中毒兔模型中评估给予氨丁三醇(THAM)或碳酸氢钠(NaHCO₃)后血浆钾(K⁺)的反应。18只健康成年雌性新西兰白兔经历严重缺氧,直至碱缺失达到-10 mEq/L。然后将兔子随机分为接受THAM溶液、NaHCO₃或不接受药物(对照组)。药物在2分钟内给予,剂量按纠正10或更高碱缺失计算。给药后45分钟测量血浆K⁺和钠(Na⁺)。给予THAM、NaHCO₃或不给予药物后,K⁺反应无差异。相比之下,与NaHCO₃或对照组相比,THAM导致Na⁺浓度显著降低(P<0.05)。在该兔模型中,给予THAM后碱化导致的K⁺变化与给予NaHCO₃后相似。在高钠血症是一个问题的患者治疗酸中毒时应考虑使用THAM。