For many years, sodium bicarbonate has proved reasonably effective for treatment of acidosis. It is also the preferred treatment of salicylate poisoning in children under the age of 2 years.1-3 Its use, however, has some disadvantages. In the first place, it is ineffective in the treatment of respiratory acidosis. Second, it must be administered with caution in certain situations, such as acute renal failure, since the amount of sodium which must be administered concomitantly may be prohibitively large.4 As Gamble has pointed out, bicarbonate is a relatively inefficient buffer at the pH of extracellular fluid, its buffering capacity being only one-fourth as great as at its isoelectric point of 6.1.5
Organic buffers have been used for in vitro buffering since 1949.6 Some have proved remarkably stable and of low toxicity, and in 1959 Nahas first reported on the use of tris(hydroxymethyl)aminomethane (THAM) in vivo.7 THAM
KAPLAN SA. Tris (Hydroxymethyl) Aminomethane (THAM)—a New Buffer for Therapeutic Use: Guest Editorial. Am J Dis Child. 1962;103(1):1–3. doi:10.1001/archpedi.1962.02080020005001
Artificial Intelligence Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.