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(Circulation. 1963;27:665.)
© 1963 American Heart Association, Inc.

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A Method for the Control of Severe Alterations in Acid-Base Equilibrium

DOUGLAS MOORE M.B.¹ WILLIAM F. BERNHARD M.D.¹

¹ From the Laboratory for Surgical Research, The Children's Hospital Medical Center, and the Department of Surgery, Harvard Medical School, Boston, Massachusetts.

Tris buffer was utilized in the prevention or treatment of profound metabolic acidosis which developed during, and immediately after, extended periods of extracorporeal circulation. In 16 patients (group I), buffer was added to the 24-hour-old heparinized priming blood prior to initiation of bypass, to counteract a low pH and high lactic acid concentration. The success of this therapy was manifested by the stability of all acid-base parameters during and following operation.

In the second group of 11 patients (group II), severe metabolic acidosis developed despite preliminary buffering of the priming blood. Here, the administration of additional buffer successfully restored acid-base equilibrium prior to the termination of perfusion.

The buffer also proved effective in the treatment of two patients who developed severe respiratory acidosis in the immediate postperfusion period, and was instrumental in the resuscitation of a final patient following a prolonged period of cardiac arrest.

It is suggested that tris buffer is a safe, potent agent for use in the prevention and treatment of acidosis from whatever cause.

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