To the Editor:— The paper by Goldenberg et al ( 205 :81, 1968) describing liver damage in infants receiving concentrated tromethamine (THAM) solution (1.2M, pH 10.2) through the umbilical vein confirms previous observations. Indeed, a review of the literature concerning the effect of the infusion of hypertonic alkaline solutions indicates that such administration does produce liver damage. Brinkman et al 1 reported in 1961 that administration of 1.5M tromethamine (pH 10.2) in a diabetic patient who subsequently died presented hydropic degeneration of liver cells as well as kidney. In 1963, it was reported that fetal rhesus monkeys treated by injection of sodium carbonate (pH 10.5, 0.7M solution, 2,100 mOsm) into the umbilical vein were found to have liver damage at the time of postmortem examination. 2 This damage was described as areas of hemorrhage with necrosis of liver cells. By contrast, diabetic patients treated with tromethamine (0.3M) did not present any microscopic
[1]
J. M. Gupta,et al.
Changes in blood gas tensions following administration of amine buffer THAM to infants with respiratory distress syndrome.
,
1967,
Archives of disease in childhood.
[2]
L. S. James,et al.
The treatment of acidosis with alkali and glucose during asphyxia in foetal rhesus monkeys
,
1963,
The Journal of physiology.
[3]
S. B. Rees,et al.
SOME IN VIVO AND IN VITRO OBSERVATIONS ON THE EFFECTS OF TRIS(HYDROXYMETHYL) AMINOMETHANE IN DIABETIC ACIDOSIS *
,
1961,
Annals of the New York Academy of Sciences.
[4]
F. Whitehouse,et al.
THE USE OF 2‐AMINO‐2‐HYDROXYMETHYL‐1, 3‐PROPANEDIOL IN THE CORRECTION OF METABOLIC AND RESPIRATORY ACIDOSIS
,
1961
.