Authors : Nahid Aghdaei, Sara Joreir Ahmadi, Khosro Farhadi and Abdolhamid Zokaei
Abstract: Metabolic acidosis or reduction of serum bicarbonate (HCO3–) concentration is a common disorder in patient with serious illness which causes morbidity and mortality in them. Buffer therapy is a major treatment to correct metabolic acidosis. In this study, the buffering effect of sodium bicarbonate and Tris Hydroxymethylaminomethane (THAM) on patients with metabolic acidosis post elective Coronary Artery Bypass Graft Surgery (CABG) was compared. Patients diagnosed with metabolic acidosis (pH<7.25, BE<5) after elective coronary artery bypass grafting were enterd into the study. In situations in which HCO administration 3 is used, the total dose required to correct the base deficit can be calculated using the equation: dose (mEq) = 0.3×weight (kg)×base deficit (mEq/L) from NaHCO3 (8/5%) solution which half this dose is usually given.In cardiac bypass surgery with metabolic acidosis, when THAM solution (ml from 0.3 M) is used the total dose can be calculated using the equation: dose: 9 mL/kg IV, maximum 500 mg/kg. Our results demonstrated that THAM reduced serum lactate, PaCO2, length of Intensive Care Unit (ICU) stay, additional dose of administration and inotrope need, compared with sodium bicarbonate. Also, THAM significantly enhanced patient’s cardiac output in comparison with sodium bicarbonate. In conclusion, our results indicated that THAM is more suitable than sodium bicarbonate in buffering metabolic acidosis post CABG.
Nahid Aghdaei, Sara Joreir Ahmadi, Khosro Farhadi and Abdolhamid Zokaei, 2017. The Effect of Sodium Bicarbonate Versus Tris-Hydroxymethyl Aminomethane on Improvement of Metabolic Acidosis in Patients Post Coronary Artery Bypass Graft Surgery. Research Journal of Pharmacology, 11: 1-5.