II. Indications
- Severe Metabolic Acidosis from Cardiac Arrest (alternative to Sodium Bicarbonate)
III. Mechanism
- Weak base binds Hydrogen Ions and excreted renally
IV. Effects
- Unlike Sodium Bicarbonate which relies on CO2 exhalation to correct Metabolic Acidosis, THAM is renally excreted
- THAM may be preferred over Sodium Bicarbonate in the non-ventilated patient with Respiratory Acidosis
- Unlike Sodium Bicarbonate which lowers Serum Potassium, THAM does not alter Potassium levels
- Unlike Sodium Bicarbonate which increases Serum Sodium, THAM lowers Serum Sodium
V. Dosing
- Dose = wtKg x baseDeficit x 1.1
VI. Precautions
- Avoid acidosis over-correction
VII. Efficacy
- As with Sodium Bicarbonate, no evidence of outcome benefit in correction of Metabolic Acidosis
VIII. Adverse effects
- Slowed Respiratory Rate
- Hypoglycemia
IX. References
- Lin and Geier in Herbert (2016) EM:Rap 16(1):14-5
- Hoste (2005) J Nephrol 18(3): 303-7 +PMID:16013019 [PubMed]