In this section you note that you have to make sure the patient is ventilated in order to use bicarb, and you correctly mention separately you have to hyperventilate a patient. But, in the context of an arrest, it's important to remember that restrained respirations (8-10min) are indicated to minimize reductions in venous return/preload. These will not work well with attempts at using sodium bicarbonate (for this purpose). Though obviously the data are scarce, I think that if we follow the logic and physiology of THAM, it makes more sense for the intra-arrest patient.
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Alex K. - January 19, 2016 6:26 PM
In this section you note that you have to make sure the patient is ventilated in order to use bicarb, and you correctly mention separately you have to hyperventilate a patient. But, in the context of an arrest, it's important to remember that restrained respirations (8-10min) are indicated to minimize reductions in venous return/preload. These will not work well with attempts at using sodium bicarbonate (for this purpose). Though obviously the data are scarce, I think that if we follow the logic and physiology of THAM, it makes more sense for the intra-arrest patient.
Ben S., Dr - October 13, 2016 1:04 AM
Is anyone using THAM pre-RSI for the metabolic acidosis patient? Seems like on a simple level it could provide us an extra margin of safety