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A Comparative Analysis of THAM (Tris-buffer) in Traumatic Brain Oedema

  • M. R. Gaab
  • K. Seegers
  • R. J. Smedema
  • H. E. Heissler
  • Ch. Goetz
Conference paper
Part of the Acta Neurochirurgica book series (NEUROCHIRURGICA, volume 51)

Summary

The effect of THAM on brain oedema parameters was initially investigated in animals with cold brain lesion; THAM was then used in head injury patients, ICP, SAP and CPP were analyzed. In the experiments with rats after freezing lesion, THAM was compared to equivalent doses of Na-bicarbonate. The animals were artificially respirated and sacrificed 6 h after trauma. THAM did significantly reduce water (wet-dry weight technique) and sodium contents in both hemispheres, whereas bicarbonate was ineffective. The potassium contents were even preserved at almost normal levels.

In 80 patients receiving alternatively THAM (18–36 g/100–200 m1/1–2 h), mannitol (20%, 125–250 ml/20–40 min) or sorbitol (40%, 70–140 ml/20–40 min), the ICP rapidly decreased following THAM infusion. The maximal fall in ICP (33%) was equal to that with mannitol and sorbitol. The slope of ICP decrease was equal with THAM and Mannitol but steeper with sorbitol. With THAM, however, the effect on ICP lasts longer than with osmotherapy. The EEG improved more rapidly after THAM. As shown by blood plasma values, the action of THAM is not based on osmotic effects. The increases in pH and especially in base excess suggest an intracerebral buffering. The encouraging results with THAM require a randomized clinical trial after severe head injury which is presently prepared.

Keywords

Brain Oedema Intracranial Hypertension Cerebral Perfusion Pressure Base Excess Sodium Content 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag 1990

Authors and Affiliations

  • M. R. Gaab
    • 1
  • K. Seegers
    • 1
  • R. J. Smedema
    • 1
  • H. E. Heissler
    • 1
  • Ch. Goetz
    • 1
  1. 1.Neurosurgical DepartmentHannover Medical SchoolHannoverFederal Republic of Germany

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