Adult Dosing
Metabolic acidosis associated with cardiac bypass surgery
- 324 mg/kg IV
- Max: 500 mg/kg/dose
Acidity of ACD blood in cardiac bypass surgery
- 0.5-2.5 g IV added to each 500 mL of ACD blood used for priming the pump-oxygenator
Correction of metabolic acidosis associated with cardiac arrest
- If chest is open
- 2-6 g IV should be injected into the ventricular cavity immediately
Note: Do not inject into the cardiac muscle
- If chest is not open
- 3.6-10.8 g IV should be injected immediately into a larger peripheral vein
Note:
- Intravenous dosage of tromethamine injection is estimated from the buffer base deficit of the extracellular fluid in mEq/liter. The formula is intended as a general guide: Tham Solution (mL of 0.3 Molar solution) required = Body Weight (kg) x Base Deficit (mEq/L) x 1.1 given by IV infusion
Pediatric Dosing
- Intravenous dosage of tromethamine injection is estimated from the buffer base deficit of the extracellular fluid in mEq/liter. The formula is intended as a general guide: Tham Solution (mL of 0.3 Molar solution) required = Body Weight (kg) x Base Deficit (mEq/L) x 1.1 given by IV infusion
- Therapy may depress ventilation, due to increased blood pH and reduced CO2 concentration. Dose should be adjusted so that blood pH is not allowed to increase above normal. In case of respiratory acidosis concomitantly with metabolic acidosis, therapy may be used with mechanical assistance to ventilation
- Caution should be exercised to prevent perivascular infiltration as this can cause inflammation, necrosis and sloughing of tissue. Venospasm and intravenous thrombosis have been occurred during infusion
- Therapy is administered slowly in amounts sufficient to correct the existing acidosis, and to avoid overdosage and alkalosis, as overdosage or rapid administration may cause hypoglycemia of a prolonged duration; monitor blood glucose during and after therapy
- Monitor patients with renal disease or reduced urinary output, as there may be possibility of a decreased excretion of tromethamine. Therapy should be used cautiously with electrocardiographic monitoring and frequent serum potassium determination
- IV administration of therapy may cause fluid and/or solute overloading resulting in dilution of serum electrolyte concentrations, overhydration, congested states or pulmonary edema
- Perform Blood pH, PCO2 bicarbonate, glucose and electrolyte determinations before, during and after administration of therapy
- May cause hypoglycemia in neonates
- May increase coagulation time
Caution: Use cautiously in
- Renal impairment
- Hepatic impairment
- Nursing mothers
Pregnancy Category:C
Breastfeeding: Safety unknown. Manufacturer advises caution.
