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The US military experience with THAM.

Gonzalo de Taboada1, Mohamad A Umar1, Monica L Casmaer1

  • 1Department of Emergency Medicine, San Antonio Military Medical Center, Fort Sam Houston, TX, United States.

The American Journal of Emergency Medicine
|January 12, 2020
PubMed
Summary
This summary is machine-generated.

Tris-hydroxymethyl aminomethane (THAM) did not increase 30-day mortality in combat casualties, despite initial concerns. Further research is needed to confirm its safety and efficacy in severe battlefield injuries.

Keywords:
AcidosisCombatMilitaryTHAMTrauma

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Area of Science:

  • Trauma Surgery
  • Critical Care Medicine
  • Military Medicine

Background:

  • Acidosis is a common complication in major combat trauma.
  • Tris-hydroxymethyl aminomethane (THAM) is used to treat acidosis.
  • The safety of THAM in military combat settings is not well-researched.

Purpose of the Study:

  • To describe the US military experience with THAM administration in battlefield injury patients.
  • To assess the association between THAM use and 30-day mortality in combat casualties.

Main Methods:

  • Retrospective descriptive cohort study using the Department of Defense Trauma Registry.
  • Analysis of US military personnel with Injury Severity Score (ISS) > 15 from 2001-2014.
  • Comparison of 30-day all-cause mortality between THAM-treated and non-THAM-treated groups.

Main Results:

  • 69 of 4558 subjects received THAM; they had higher ISS and required more blood transfusions.
  • THAM recipients experienced longer ICU/ventilator days and lower survival to discharge.
  • Multivariable analysis, after controlling for confounders, showed THAM use was not associated with increased mortality.

Conclusions:

  • THAM administration was not associated with increased 30-day mortality in this combat trauma population.
  • Further prospective studies are required to validate THAM's use in critically injured combat casualties.