Effects of THAM and sodium bicarbonate on intracranial pressure and mean arterial pressure in an animal model of focal cerebral injury

S. E. Duthie, G. D. Goulin, Mark Zornow, M. S. Scheller, B. M. Peterson

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Episodes of arterial hypotension are associated with an increased mortality in head injury patients. Rapid infusion of sodium bicarbonate in such patients may cause hypotension and elevate intracranial pressure. Therefore, we examined the effects of tromethamine (THAM) versus bicarbonate on intracranial pressure and blood pressure in a model of focal cerebral injury. THAM is a buffer that in previous studies has been shown to lower intracranial pressure. After creation of a cryogenic lesion in 13 New Zealand white rabbits, equivalent infusions (15 s duration) of sodium bicarbonate and THAM (2 mEq/kg) were administered sequentially to each animal in random order. Rapid infusion was chosen to simulate the administration of these drugs during a resuscitation. THAM infusion was associated with a significantly lower intracranial pressure and blood pressure than bicarbonate. The fall in blood pressure was great enough that cerebral perfusion pressure after THAM infusion was significantly lower than after bicarbonate infusion. In this model of cerebral injury, rapid infusion of THAM offered no therapeutic advantage over bicarbonate.

Original languageEnglish (US)
Pages (from-to)201-208
Number of pages8
JournalJournal of Neurosurgical Anesthesiology
Volume6
Issue number3
StatePublished - 1994
Externally publishedYes

Fingerprint

Tromethamine
Sodium Bicarbonate
Intracranial Pressure
Arterial Pressure
Animal Models
Bicarbonates
Wounds and Injuries
Blood Pressure
Hypotension
Cerebrovascular Circulation
Craniocerebral Trauma
Resuscitation
Buffers
Rabbits
Mortality
Pharmaceutical Preparations

Keywords

  • Brain injury
  • Cerebral perfusion pressure
  • Intracranial hypertension
  • Intracranial pressure
  • Sodium bicarbonate
  • THAM

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Clinical Neurology

Cite this

Effects of THAM and sodium bicarbonate on intracranial pressure and mean arterial pressure in an animal model of focal cerebral injury. / Duthie, S. E.; Goulin, G. D.; Zornow, Mark; Scheller, M. S.; Peterson, B. M.

In: Journal of Neurosurgical Anesthesiology, Vol. 6, No. 3, 1994, p. 201-208.

Research output: Contribution to journalArticle

@article{c40ba35cb65a4a2299ba9aad60af484a,
title = "Effects of THAM and sodium bicarbonate on intracranial pressure and mean arterial pressure in an animal model of focal cerebral injury",
abstract = "Episodes of arterial hypotension are associated with an increased mortality in head injury patients. Rapid infusion of sodium bicarbonate in such patients may cause hypotension and elevate intracranial pressure. Therefore, we examined the effects of tromethamine (THAM) versus bicarbonate on intracranial pressure and blood pressure in a model of focal cerebral injury. THAM is a buffer that in previous studies has been shown to lower intracranial pressure. After creation of a cryogenic lesion in 13 New Zealand white rabbits, equivalent infusions (15 s duration) of sodium bicarbonate and THAM (2 mEq/kg) were administered sequentially to each animal in random order. Rapid infusion was chosen to simulate the administration of these drugs during a resuscitation. THAM infusion was associated with a significantly lower intracranial pressure and blood pressure than bicarbonate. The fall in blood pressure was great enough that cerebral perfusion pressure after THAM infusion was significantly lower than after bicarbonate infusion. In this model of cerebral injury, rapid infusion of THAM offered no therapeutic advantage over bicarbonate.",
keywords = "Brain injury, Cerebral perfusion pressure, Intracranial hypertension, Intracranial pressure, Sodium bicarbonate, THAM",
author = "Duthie, {S. E.} and Goulin, {G. D.} and Mark Zornow and Scheller, {M. S.} and Peterson, {B. M.}",
year = "1994",
language = "English (US)",
volume = "6",
pages = "201--208",
journal = "Journal of Neurosurgical Anesthesiology",
issn = "0898-4921",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Effects of THAM and sodium bicarbonate on intracranial pressure and mean arterial pressure in an animal model of focal cerebral injury

AU - Duthie, S. E.

AU - Goulin, G. D.

AU - Zornow, Mark

AU - Scheller, M. S.

AU - Peterson, B. M.

PY - 1994

Y1 - 1994

N2 - Episodes of arterial hypotension are associated with an increased mortality in head injury patients. Rapid infusion of sodium bicarbonate in such patients may cause hypotension and elevate intracranial pressure. Therefore, we examined the effects of tromethamine (THAM) versus bicarbonate on intracranial pressure and blood pressure in a model of focal cerebral injury. THAM is a buffer that in previous studies has been shown to lower intracranial pressure. After creation of a cryogenic lesion in 13 New Zealand white rabbits, equivalent infusions (15 s duration) of sodium bicarbonate and THAM (2 mEq/kg) were administered sequentially to each animal in random order. Rapid infusion was chosen to simulate the administration of these drugs during a resuscitation. THAM infusion was associated with a significantly lower intracranial pressure and blood pressure than bicarbonate. The fall in blood pressure was great enough that cerebral perfusion pressure after THAM infusion was significantly lower than after bicarbonate infusion. In this model of cerebral injury, rapid infusion of THAM offered no therapeutic advantage over bicarbonate.

AB - Episodes of arterial hypotension are associated with an increased mortality in head injury patients. Rapid infusion of sodium bicarbonate in such patients may cause hypotension and elevate intracranial pressure. Therefore, we examined the effects of tromethamine (THAM) versus bicarbonate on intracranial pressure and blood pressure in a model of focal cerebral injury. THAM is a buffer that in previous studies has been shown to lower intracranial pressure. After creation of a cryogenic lesion in 13 New Zealand white rabbits, equivalent infusions (15 s duration) of sodium bicarbonate and THAM (2 mEq/kg) were administered sequentially to each animal in random order. Rapid infusion was chosen to simulate the administration of these drugs during a resuscitation. THAM infusion was associated with a significantly lower intracranial pressure and blood pressure than bicarbonate. The fall in blood pressure was great enough that cerebral perfusion pressure after THAM infusion was significantly lower than after bicarbonate infusion. In this model of cerebral injury, rapid infusion of THAM offered no therapeutic advantage over bicarbonate.

KW - Brain injury

KW - Cerebral perfusion pressure

KW - Intracranial hypertension

KW - Intracranial pressure

KW - Sodium bicarbonate

KW - THAM

UR - http://www.scopus.com/inward/record.url?scp=0028245722&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028245722&partnerID=8YFLogxK

M3 - Article

C2 - 8081100

AN - SCOPUS:0028245722

VL - 6

SP - 201

EP - 208

JO - Journal of Neurosurgical Anesthesiology

JF - Journal of Neurosurgical Anesthesiology

SN - 0898-4921

IS - 3

ER -