Infant Data
Results
INDICATIONS
- Treatment of metabolic acidosis, primarily in mechanically ventilated patients with significant hypercarbia or hypernatremia.
- Do not use in patients who are anuric or uremic.
- THAM is not indicated for treatment of metabolic acidosis caused by bicarbonate deficiency.
CONTRAINDICATIONS
Most reports of toxicity in neonates (hypoglycemia, hyperkalemia, liver necrosis) were relat to rapid umbilical venous infusion of high doses of THAM base solutions that were more alkaline and hypertonic than the THAM acetate solution currently available from Abbott (pH 8.6; osmolarity 380 mOsm/L). Irritating to veins.
ADMINISTRATION
Administer by slow IV infusion over at least 30 to 60 minutes. Rate of infusion should not exceed 2 mmol/kg in 30 minutes or 5 mmol/kg in 60 minutes. Infusion into a large vein is recommended (peripheral or umbilical vein may be used). Has also been administered with 25% to 50% of the calculated dose given intravenously over 5 to 10 minutes with the remainder given intravenously over 1 to 6 hours.
MONITORING
Observe IV site closely for signs of extravasation. Follow blood-gas results to assess therapeutic efficacy. Follow urine output. Monitor for respiratory depression, hypoglycemia, and hyperkalemia when using several doses.