Bicarb Alternatives: Sodium Acetate & Balanced Crystalloids

Editor’s Note:   Authorization for the contributions below were obtained from each contributor via email.  Please see comments section… THAM A a Buffer Tham Description Tham Solution (tromeThamine injection) is a sterile, non-pyrogenic 0.3 M solution of tromeThamine, adjusted to a pH of approximately 8.6 with glacial acetic acid. It is administered by intravenous injection, by […]

The MgSO4 Shortage: Now We Know Why …

Click Image to View Drug Shortages Listed on the Site … Was it Real ? UPDATE ! Yeah …  It was. Click image to view source article … Nurse spotted mold-tainted drugs right away, hospital says By JoNel Aleccia, Senior Writer, NBC News A sharp-eyed nurse at Yale-New Haven Hospital in Connecticut is being credited […]

HELP ! Potassium Acetate as a work-around for KCL Shortage ?

Editors Note: Have any of you out there ever used or considered using Potassium Acetate as a work around for KCL Shortage? I personally have zero experience with it- but the thought had crossed my mind in light of the current situation.  I saw this post from Jim Patterson, CCP on Perflist and asked him […]

KCL Shortage UPDATE

Most Recent Resupply Dates 2 mEq/mL; 20 mL vial (NDC 0409-6653-05) (Standard) Next delivery June 10 mEq/100 mL (NDC 00409-7074-26) Ample supplies available to meet market demand. 10 mEq/50 mL (NDC 00409-7075-14) Ample supplies available to meet market demand. 20 mEq/100 mL, (NDC00409-7075-26) Ample supplies available to meet market demand. 20 mEq/50 mL (NDC 00409-7077-14) […]

KCL Shortage ? FYI ( Yeah There Is … )

Is it Real ? UPDATE ! Yeah …  It is. I was just informed we have enough at one of our hospitals for 16 cases… Any suggestions on resources ??? More Recent Resupply Dates 2 mEq/mL; 20 mL vial (NDC 0409-6653-05) (Standard) Next delivery June 10 mEq/100 mL (NDC 00409-7074-26) Ample supplies available to meet […]

Are Drug Shortages the New Status Quo ?

Click above to view source article Editors Note: A List of articles on Perfusion related Med Shortages Below: Protamine MgSO4 Amicar NaHCO3 KCl WASHINGTON — At the Henry Ford Hospital in Detroit, pharmacists are using old-fashioned paper spreadsheets to track their stock of drugs in short supply – a task that takes several hours each day. […]

Bicarb Alternatives: Sodium Acetate & Balanced Crystalloids

Editor’s Note: Authorization for the contributions below were obtained from each contributor via email.  Please see comments section… Balanced Crystalloids “For those who are still using bicarb in your prime. There is some literature that states the occurrence of acidosis at the start of bypass is an iatrogenic event, that is due to the choices […]

Welcome to the New World : THAM

Click Image to View Source Article… Tham Dosage and Administration (ADULT Calculation) Tham Solution (mL of 0.3 M) Required = Kg x Base deficit x 1.1* Thus, a 70 kg patient with a buffer base deficit (“negative base excess”) of 5 mEq/liter would require 70 x 5 x 1.1 = 385 mL of Tham Solution […]

2016: Sodium Bicarbonate Shortage

UPDATE:  2/22/2016 From:  Bryan Lich, CCP Please be advised that you will soon be experiencing a Biarb shortage at your hospital, so please use it sparingly. http://www.ashp.org/menu/DrugShortages/ResolvedShortages/bulletin.aspx?id=788 Thanks, News Release Sodium Bicarbonate Injection [29 January 2016] Products Affected – Description Sodium Bicarbonate injection, Amphastar 8.4%, 50 mL syringe, 10 count (NDC 76329-3352-01) 8.4%, 50 mL […]

THAM As an Alternative Buffer

Tham Description Tham Solution (tromeThamine injection) is a sterile, non-pyrogenic 0.3 M solution of tromeThamine, adjusted to a pH of approximately 8.6 with glacial acetic acid. It is administered by intravenous injection, by addition to ACD blood for priming cardiac bypass equipment and by injection into the ventricular cavity during cardiac arrest. Each 100 mL […]

Tranexamic Acid Protocols ?

Editor’s Note:   This is in answer to a previous question posted regarding Tranexamic Dosing Protocols: Dosing Implications: (see last article below for source) A 10 mg/kg initial dose of tranexamic acid Followed by an infusion of 1 mg.kg(-1).h(-1) produced plasma concentrations throughout the cardiopulmonary bypass period sufficient to inhibit fibrinolysis in vitro. QUESTION: Does […]

And Now… Amicar ?

Another Questionable Availability Issue… (Click Image to View Source) I would get on top of this as soon as possible.  Amicar is a generic yet essential part of life if conducting Cardiopulmonary Bypass. 1st Protamine Then Magnesium Sulfate Now Epsilon Aminocaproic Acid (EACA  aka Amicar) Is there a common denominator?  Hospira Inc ….Click Image to […]