심장 수술 환자에서 Tris-Hydroxymethyl Aminomethane (THAM) 대 Sodium Bicarbonate의 비교 연구

Patients randomized to the THAM arm will be treated with tris-hydroxymethyl aminomethane.

Dosage: Base excess less than -5, administer 500 mL of THAM

Patients in the ICU following cardiothoracic surgery with use of cardiopulmonary bypass, requiring treatment for metabolic acidosis (base excess less than -5), will receive tris-hydroxymethyl aminomethane (THAM) if randomized to the THAM arm.

• THAM

Patients randomized to the Bicarb arm will be treated with sodium bicarbonate (Bicarb).

Dosage: Base excess less than -5, administer 100 mEq of sodium bicarbonate

Patients in the ICU following cardiothoracic surgery with use of cardiopulmonary bypass and requiring treatment for metabolic acidosis (base excess less than -5), will receive sodium bicarbonate (Bicarb) if randomized to the Bicarb arm.

• Bicarb

pH will be measured via arterial blood gas test

Sodium will be measured via blood test and reported in reported in mEq/L (milliequivalents per liter)

Potassium will be measured via blood test and reported in reported in mEq/L (milliequivalents per liter)

Lactate will be measured via blood test and reported in mmol/L (millimoles per liter)

PaCO2 will be measured via arterial blood gas test, reported as mmHg (millimeters of mercury)

Cardiac index is determined by dividing cardiac output by body surface area, with a normal range of 2.5-4.0 L/min/m²

Mean arterial pressure (MAP) is the average pressure in the arteries throughout one cardiac cycle. Normal MAP is between 70 and 100, reported as mmHg (millimeters of mercury)

Duration of mechanical ventilation will be reported in hours

Number of patients who develop acute kidney injury

Number of patients who newly require renal replacement therapy

Number of days patient stays in ICU

Number of days patient is hospitalized