Tierexperimentelle Studie zur Beeinflussung des erhöhten intrakraniellen Druckes durch THAM (Trishydroxymethylaminomethan) und Natriumbikarbonat

Abstract

Intracranial pressure was increased by means of an epidural balloon in 21 young pigs anaesthetised with air/O2 and burprenorphine. Sodium bicarbonate (1 mmol/kg BW) was administered intravenously in 10 animals; THAM (tris-hydroxymethylaminomethane) (1 mmol/kg BW), in 11. Intracranial pressure declined significantly under THAM, from 4.35 kPa in the middle of the infusion to 3.92 kPa at the end, and continued to drop for 15 minutes after its termination. No changes in intracranial pressure, however, were observed in the bicarbonate group. Since mean arterial blood pressure was unchanged in both groups, the increase in cerebral perfusion pressure was significant in the THAM group, but not in the bicarbonate group. Our results, therefore, indicate that THAM is preferable to bicarbonate for correcting acidosis in acute craniocerebral trauma. Controlled ventilation, however, remains indispensable.