Two buffers (sodium bicarbonate and THAM) were used in a controlled trial for treatment of severe idiopathic respiratory distress syndrome. The results indicate that THAM is marginally superior to sodium bicarbonate. 1 infant died as a result of direct toxic effect of THAM because of inadvertent administration of a hyperosmolar solution of THAM. Blood gas analysis indicated that THAM caused a rise in Po2 in a number of cases (7 out of 18), and a fall in Pco2 in 13 out of 21 cases where blood gas determinations had been done before and after treatment. In contrast, bicarbonate caused no change in Po2 and a rise in Pco2 in 5 of 16 cases where blood gas determinations had been carried out before and after treatment. Apnoea due to THAM administration was not encountered. The incidence of intraventricular haemorrhage was not different in the 2 groups.
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