Akademik Veri Yönetim Sistemi
Eurasian J Critical Care, cilt.3, sa.3, ss.98-104, 2021 (Hakemli Dergi)
Abstract
Background: Treatment of acidosis is serious health problem within emergency departments and intensive care units etc. Ingestion of household cleaning
solutions (due to both suicidal and accidental reasons) is still also a serious public health problem in Turkey and the most fatal complication thereof is,
severe metabolic acidosis. An effective treatment should be provided for the cases presenting to emergency departments with life-threatening metabolic
acidosis.
Aim: We aimed to compare the survival rate of rats with experimental metabolic acidosis created by intragastric administration of hydrochloric acid and
treated with “tris–hydroxymethyl aminomethane” or normal saline solution alone.
Study Design: This was an experimental animal study.
Methods: Following ketamine-xylazine anesthesia, internal carotid artery of fourteen female Wistar albino rat was cannulated, basal blood samples were
drawn and esophagus of each was cannulated with intracath. Hydrochloric acid was subsequently poured through the cannula towards stomach. After 30
minutes, blood gas status was checked in order to see if acidosis occurred or not. The rats which developed acidosis were randomly divided into “tris-hydroxymethyl aminomethane” and “normal saline solution” groups. Later the treatment with IV tris-hydroxymethyl aminomethane or normal saline was
initiated. At 30th and 60th minutes of the treatment, pH, PaO2
, HCO3
, PaCO2
and base deficit parameters were checked through arterial blood gas samples to
monitor the efficacy of the treatment. At the end of the second hour of the study, the experiment was finalized and the survival of rats was documented.
Results: Following the development of experimental metabolic acidosis in rats by ingestion of intragastric hydrochloric acid, four rats in tris–hydroxymethyl
aminomethane and six rats in normal saline group died prior to the end of the follow-up period.
This finding was statistically significant. There was no statistically significant difference between tris–hydroxymethyl aminomethane and normal saline
groups with regard to body temperature, blood pressure, heart rate, PaCO2
and PaO2
. However, the comparison of two groups with respect to survival indicated a significant difference (p<0.05). pH at 60th minute in tris–hydroxymethyl aminomethane group was significantly lower compared to that in normal
saline group (p<0.05), and base deficit values at 30th and 60th minutes in tris–hydroxymethyl aminomethane group were significantly higher compared to
that in normal saline group (p<0.05).
Conclusion: In this experimental rat model, we observed that treatment with IV tris–hydroxymethyl aminomethane prolonged the survival of rats with
experimental metabolic acidosis created by ingestion of hydrochloric acid compared to the treatment with normal saline solution.
Key words: Metabolic acidosis, hydrochloric acid, tris–hydroxymethyl aminomethane, sodium bicarbonate