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Tromethamine

Alias: Trometamol; TROMETHAMINE; 77-86-1; Tris(Hydroxymethyl)aminomethane; Tris; Tham; 2-Amino-2-(hydroxymethyl)propane-1,3-diol; Trisamine;
Cat No.:V12636 Purity: ≥98%
THAM (Tris) is a bioinert aminoalcohol with low toxicity that buffers carbon dioxide and acids in vivo and in vitro.
Tromethamine
Tromethamine Chemical Structure CAS No.: 77-86-1
Product category: New1
This product is for research use only, not for human use. We do not sell to patients.
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Other Forms of Tromethamine:

  • THAM hydrochloride (reagent grade) (Tris hydrochloride (reagent grade); Tris(hydroxymethyl)aminomethane hydrochloride (reagent grade))
  • Trometamol acetate
Official Supplier of:
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Top Publications Citing lnvivochem Products
Product Description
THAM (Tris) is a bioinert aminoalcohol with low toxicity that buffers carbon dioxide and acids in vivo and in vitro. THAM is an effective amine compound that controls pH within the physiological range.
Biological Activity I Assay Protocols (From Reference)
Targets
Biochemical reagent
ln Vitro
Tris(hydroxymethyl)aminomethane hydrochloride is a biochemical reagent that can be utilized in research pertaining to life sciences as an organic compound or biological material. THAM (trometamol; tris-hydroxymethyl aminomethane) is a biologically inert amino alcohol of low toxicity, which buffers carbon dioxide and acids in vitro and in vivo. At 37 degrees C, the pK (the pH at which the weak conjugate acid or base in the solution is 50% ionised) of THAM is 7.8, making it a more effective buffer than bicarbonate in the physiological range of blood pH. THAM is a proton acceptor with a stoichiometric equivalence of titrating 1 proton per molecule.[1]
ln Vivo
In vivo, THAM supplements the buffering capacity of the blood bicarbonate system, accepting a proton, generating bicarbonate and decreasing the partial pressure of carbon dioxide in arterial blood (paCO2). It rapidly distributes through the extracellular space and slowly penetrates the intracellular space, except for erythrocytes and hepatocytes, and it is excreted by the kidney in its protonated form at a rate that slightly exceeds creatinine clearance. Unlike bicarbonate, which requires an open system for carbon dioxide elimination in order to exert its buffering effect, THAM is effective in a closed or semiclosed system, and maintains its buffering power in the presence of hypothermia. THAM rapidly restores pH and acid-base regulation in acidaemia caused by carbon dioxide retention or metabolic acid accumulation, which have the potential to impair organ function. Tissue irritation and venous thrombosis at the site of administration occurs with THAM base (pH 10.4) administered through a peripheral or umbilical vein: THAM acetate 0.3 mol/L (pH 8.6) is well tolerated, does not cause tissue or venous irritation and is the only formulation available in the US. In large doses, THAM may induce respiratory depression and hypoglycaemia, which will require ventilatory assistance and glucose administration. The initial loading dose of THAM acetate 0.3 mol/L in the treatment of acidaemia may be estimated as follows: THAM (ml of 0.3 mol/L solution) = lean body-weight (kg) x base deficit (mmol/L). The maximum daily dose is 15 mmol/kg for an adult (3.5L of a 0.3 mol/L solution in a 70kg patient). When disturbances result in severe hypercapnic or metabolic acidaemia, which overwhelms the capacity of normal pH homeostatic mechanisms (pH < or = 7.20), the use of THAM within a 'therapeutic window' is an effective therapy. It may restore the pH of the internal milieu, thus permitting the homeostatic mechanisms of acid-base regulation to assume their normal function. In the treatment of respiratory failure, THAM has been used in conjunction with hypothermia and controlled hypercapnia. Other indications are diabetic or renal acidosis, salicylate or barbiturate intoxication, and increased intracranial pressure associated with cerebral trauma. THAM is also used in cardioplegic solutions, during liver transplantation and for chemolysis of renal calculi. THAM administration must follow established guidelines, along with concurrent monitoring of acid-base status (blood gas analysis), ventilation, and plasma electrolytes and glucose.[1]
In the controls, the decrease in VT from 6 to 3 ml/kg increased PaCO2 from 6.0±0.5 to 13.8±1.5 kPa and lowered pH from 7.40±0.01 to 7.12±0.06, whereas base excess (BE) remained stable at 2.7±2.3 mEq/L to 3.4±3.2 mEq/L. In the THAM groups, PaCO2 decreased and pH increased above 7.4 during the infusions. After discontinuing the infusions, PaCO2 increased above the corresponding level of the controls (15.2±1.7 kPa and 22.6±3.3 kPa for 1-h and 3-h THAM infusions, respectively). Despite a marked increase in BE (13.8±3.5 and 31.2±2.2 for 1-h and 3-h THAM infusions, respectively), pH became similar to the corresponding levels of the controls. PVR was lower in the THAM groups (at 6 h, 329±77 dyn∙s/m(5) and 255±43 dyn∙s/m(5) in the 1-h and 3-h groups, respectively, compared with 450±141 dyn∙s/m(5) in the controls), as were pulmonary arterial pressures.
Conclusions: The pH in the THAM groups was similar to pH in the controls at 6 h, despite a marked increase in BE. This was due to an increase in PaCO2 after stopping the THAM infusion, possibly by intracellular release of CO2. Pulmonary arterial pressure and PVR were lower in the THAM-treated animals, indicating that THAM may be an option to reduce PVR in acute hypercapnia.[2]
Animal Protocol
A one-hit injury ARDS model was established by repeated lung lavages in 18 piglets. After ventilation with VT of 6 ml/kg to maintain normocapnia, VT was reduced to 3 ml/kg to induce hypercapnia. Six animals received THAM for 1 h, six for 3 h, and six serving as controls received no THAM. In all, the experiment continued for 6 h. The THAM dosage was calculated to normalize pH and exhibit a lasting effect. Gas exchange, pulmonary, and systemic hemodynamics were tracked. Inflammatory markers were obtained at the end of the experiment.[2]
ADME/Pharmacokinetics
Absorption, Distribution and Excretion
Tromethamine is primarily excreted via the kidneys. Ionized tromethamine (mainly in bicarbonate form) is rapidly and preferentially excreted in the urine, with the excretion rate depending on the infusion rate. The manufacturer states that urinary excretion can continue for up to 3 days; after 8 hours, 75% or more of the drug is present in the urine. Some studies suggest that 50-75% of the intravenously administered dose is recovered from the urine within 24 hours, but another study reported recovery rates of 64% and 77% after 2 and 3 days, respectively, in healthy adults. It is currently unclear whether tromethamine is distributed into human breast milk. Ionized tromethamine is excreted via the kidneys, thus its function is to remove hydrogen ions. The drug is completely eliminated from the body via renal excretion. Tromethamine excretion is accompanied by osmotic diuresis, as clinical doses of tromethamine significantly increase the osmotic pressure of the glomerular filtrate. This study investigated the renal excretion of tris(hydroxymethyl)aminomethane (THAM) in rats of different ages (5 to 240 days old). Results showed that THAM excretion was slower in 5-day-old and 240-day-old rats than in other age groups. Intraperitoneal injection of mannitol, thiazide diuretics, or oral administration of large amounts of water to stimulate diuresis increased THAM excretion in both 5-day-old and 240-day-old rats. Repeated administration of THAM to all age groups, except newborn rats, also increased THAM renal excretion. The possible mechanism of action was explored. Under a constant plasma pH of 7.4, the distribution of THAM labeled with 14C in the intracellular and extracellular spaces of nephrectomized Sprague-Dawley rats was measured over time. Results showed that the equilibrium between the extracellular and intracellular spaces of THAM was not reached within 6–12 hours after administration. This indicates that THAM penetrates into cells very slowly, contrary to the common belief that THAM diffuses rapidly into cells to restore intracellular acidosis. THAM disappears from the extracellular space in a multi-exponential manner, indicating significant differences in its equilibrium rates with different body tissues. The equilibrium achieved between the two fluid compartments 6–12 hours after THAM administration does not conform to expectations considering only the transport of non-ionized substances. At a plasma pH of 7.4 and a mean systemic pH of 6.88, the distribution ratio of THAM was 4 (ICS/ECS), far exceeding the expected value of 11 for non-ionized diffusion. Therefore, THAM also crosses the cell membrane in an ionized form. These results suggest that the rate of THAM influx into cells is too slow (compared to renal clearance kinetics) to significantly affect intracellular pH through direct buffering. Furthermore, only a portion of THAM enters cells in a non-ionized form, thus (to a greater extent) reducing the direct effect of THAM on intracellular acid-base balance. Metabolism/Metabolites: Metabolism of tromethamine is not evident.
Toxicity/Toxicokinetics
Human Toxicity Excerpt
/Human Exposure Studies/ In studies of tromethamine administration to healthy individuals, respiratory rate remained constant, but decreased tidal volume led to a decrease in minute ventilation and carbon dioxide output; arterial oxygen saturation decreased by an average of approximately 5%.
/Signs and Symptoms/ Rapid and/or excessive administration of tromethamine may lead to alkalosis, hypoglycemia, hyperhydration, or solute overload.
Non-Human Toxicity Excerpt
/Laboratory Animals: Acute Exposure/ Even after neutralization, oral administration of high doses of tromethamine to laboratory animals resulted in weakness, syncope, and coma (without seizures). Injection of high doses of tromethamine to animals caused hypoglycemia, but simultaneous glucose supplementation did not prevent death.
Non-human toxicity values
Rat intravenous LD50: 2300 mg/kg
Rat oral LD50: 5900 mg/kg
Mouse intravenous LD50: 3500 mg/kg
Environmental fate/exposure overview
Grammatical alcohol is used as an emulsifier in the synthesis of surfactants and vulcanization accelerators. Its production and use may result in the release of tromethamine into the environment through various waste streams. If released into the air, the estimated vapor pressure at 25°C is 2.2 × 10⁻⁵ mmHg, indicating that tromethamine is expected to exist in the atmosphere in both gaseous and particulate phases. Gaseous tromethamine degrades in the atmosphere by reacting with photochemically generated hydroxyl radicals; the half-life of this reaction in the air is estimated to be 11 hours. Particulate tromethamine is removed from the atmosphere by dry and wet deposition. Tromethamine does not contain chromophores with absorption wavelengths greater than 290 nm, therefore it is not expected to be subject to direct photolysis by sunlight. If released into soil, its Koc value is estimated to be 1, indicating high mobility of tromethamine in soil. Tromethamine has a pKa value of 8.07. Therefore, this compound exists in the environment partially in cationic form, and cations are generally more readily adsorbed onto organic carbon and clay than neutral molecules. Thus, the adsorption of tromethamine may be higher than indicated by its Koc value, while its mobility may be lower than estimated. Since the cationic form is non-volatile, and the Henry's Law constant for the neutral form (free base) of tromethamine is estimated at 8.7 × 10⁻¹³ atm·m³/mol, tromethamine is not expected to volatilize from moist soil. Based on its estimated vapor pressure, tromethamine is also not expected to volatilize from dry soil surfaces. No oxygen uptake was observed when tromethamine was co-cultured with pure cultures of different strains, suggesting that its biodegradation in the environment may be relatively slow. Based on the estimated Koc value, tromethamine is not expected to adsorb onto suspended matter and sediment after release into water. However, based on its pKa value of 8.07, it should exist partially in cationic form under ambient conditions (pH 5–9). Therefore, the adsorption capacity of tromethamine on suspended matter and sediment is likely higher than its estimated Koc value. Since the cation is non-volatile, and considering the Henry's Law constant for neutral substances, volatilization from the water surface is not a significant fate process. The estimated BCF value of 3 indicates a low likelihood of bioaccumulation in aquatic organisms. Hydrolysis is not expected to be a significant environmental fate process as the compound lacks functional groups that are hydrolyzable under ambient conditions. Occupational exposure to tromethamine may occur through inhalation and skin contact in workplaces where it is produced or used. (SRC)
Non-human toxicity values
Rat intravenous LD50: 2300 mg/kg
Rat oral LD50: 5900 mg/kg
Mouse intravenous LD50: 3500 mg/kg
References

[1]. Guidelines for the treatment of acidaemia with THAM. Drugs. 1998 Feb;55(2):191-224.

[2]. THAM reduces CO2-associated increase in pulmonary vascular resistance - an experimental study in lung-injured piglets. Crit Care. 2015 Sep 17;19(1):331.

Additional Infomation
Tris is a primary amine compound, a derivative of tert-butylamine, in which one hydrogen atom on each methyl group is replaced by a hydroxyl group. It is widely used as a biological buffer in the pH range of 7-9; pKa = 8.3 at 20°C; pKa = 7.82 at 37°C. It has buffering properties. It is a triol and a primary amine compound. It is the conjugate base of a member of the Htris family. It is an organic amine proton acceptor. It is used in the synthesis of surfactants and pharmaceuticals; as an emulsifier in cosmetic creams and lotions, mineral oil and paraffin emulsions; as a biological buffer; and as an alkalizing agent. (Cited from Merck, 11th edition; Martindale, Pharmacopoeia Supplement, 30th edition, p. 1424) (Quoted from Merck Pharmacopoeia 11th Edition; Martindale Pharmacopoeia 30th Edition, p. 1424)
See also: Tromethamine hydrochloride (active ingredient); Potassium chloride; Sodium chloride; Tromethamine (ingredient)...See more...
Drug Indications
For the prevention and correction of metabolic acidosis.
FDA Label
Mechanism of Action
Tromethamine is an alkalizing agent that acts as a proton (hydrogen ion) acceptor. Tromethamine is a weak base; after intravenous injection, it attracts and binds to hydrogen ions and their associated acid anions, and the resulting salts are excreted in the urine. Tromethamine can bind to lactate, pyruvate and other metabolic acids, as well as carbonic acid. At pH 7.4, approximately 70% of tromethamine in plasma is in an ionized (protonated) form; if the pH is below 7.4, the ionized portion of the drug increases. Unlike the ionized portion of tromethamine, which reacts only with acids in the extracellular fluid after administration, the dose fraction that remains unionized at physiological pH is thought to be able to penetrate cell membranes and bind to intracellular acids. Because tromethamine administration lowers hydrogen ion concentration, proton donor concentrations in the body's buffer solution decrease, while proton acceptor concentrations increase. In bicarbonate:carbonate buffer, dissolved carbon dioxide concentrations decrease (at least before regulatory mechanisms compensate), while bicarbonate concentrations increase. The decrease in carbon dioxide partial pressure eliminates the potent stimulus to respiration and may lead to hypoventilation and hypoxia. Tromethamine…is a weak osmotic diuretic that increases the flow rate of alkaline urine containing large amounts of electrolytes. By removing protons from hydrogen ions, the ionization of carbonic acid is altered, thereby lowering the carbon dioxide partial pressure (pCO2) and increasing the bicarbonate ion concentration. Excess bicarbonate ions are then gradually excreted through the kidneys. Tromethamine is a particularly effective treatment for high partial pressure of carbon dioxide (pCO2) in respiratory acidosis…
Therapeutic Use
Buffer; Excipients
Tromethamine is indicated for the prevention and correction of metabolic acidosis. /US Product Label Includes/
Metabolic acidosis associated with coronary artery bypass surgery. Studies have found that tromethamine solution is primarily used to correct metabolic acidosis occurring during or immediately after coronary artery bypass surgery. /US Product Label Includes/
Correction of ACD blood acidity during coronary artery bypass surgery. ACD blood is known to be acidic, and this acidity can increase further upon storage. Tromethamine effectively corrects this acidity. Tromethamine solution can be added directly to the blood used for pre-filling a cardiopulmonary bypass machine. When the pH of the ACD blood returns to the normal range, the patient avoids an initial acid load. If metabolic acidosis occurs during coronary artery bypass surgery, additional tromethamine may be required. /US Product Labels Include/
For more complete data on the therapeutic uses of tromethamine (6 types), please visit the HSDB record page.
Drug Warnings
Local reactions associated with tromethamine administration may include local irritation and tissue inflammation or infection at the injection site, febrile reaction, chemical phlebitis, venous spasm, hypervolemia, and venous thrombosis.To minimize irritation to veins from highly alkaline tromethamine solutions, administration should be done using a large-bore needle or indwelling catheter. Extravasation may cause inflammation, necrosis, and shedding of the covering skin. If perivascular infiltration occurs, tromethamine administration should be discontinued immediately. Infiltrating the affected area with a 1% procaine hydrochloride solution containing hyaluronidase can usually relieve venous spasm and dilute residual tromethamine in the local tissue. Local infiltration of an alpha-adrenergic blocker, such as phentolamine mesylate, into the vasospastic area is recommended. If necessary, nerve blocks may be applied to the autonomic nerve fibers at the affected area.
A transient drop in blood glucose levels may occur during tromethamine administration. Hypoglycemia may persist for several hours after discontinuation if the recommended dose is used or the administration rate is too rapid.
Tromethamine should be administered slowly, with the dose only sufficient to correct existing acidosis to avoid overdose and alkalosis. Blood glucose levels should be monitored frequently during and after treatment.
Patients receiving high-dose tromethamine may experience respiratory depression due to increased blood pH and decreased carbon dioxide levels, as well as in patients with chronic hypoventilation or those taking other respiratory depressant medications. The dose must be carefully adjusted to keep blood pH below normal, and mechanical ventilation should be available at all times during tromethamine administration. If both respiratory and metabolic acidosis are present, tromethamine may be used in combination with mechanical ventilation support.
For more complete data on tromethamine (18 in total), please visit the HSDB records page.
These protocols are for reference only. InvivoChem does not independently validate these methods.
Physicochemical Properties
Molecular Formula
C4H11NO3
Molecular Weight
121.1350
Exact Mass
121.073
Elemental Analysis
C, 39.66; H, 9.15; N, 11.56; O, 39.62
CAS #
77-86-1
Related CAS #
THAM hydrochloride;1185-53-1;THAM acetate;6850-28-8
PubChem CID
6503
Appearance
White to off-white solid powder
Density
1.3±0.1 g/cm3
Boiling Point
357.0±37.0 °C at 760 mmHg
Melting Point
167-172 °C(lit.)
Flash Point
169.7±26.5 °C
Vapour Pressure
0.0±1.8 mmHg at 25°C
Index of Refraction
1.544
LogP
-1.38
Hydrogen Bond Donor Count
4
Hydrogen Bond Acceptor Count
4
Rotatable Bond Count
3
Heavy Atom Count
8
Complexity
54
Defined Atom Stereocenter Count
0
InChi Key
LENZDBCJOHFCAS-UHFFFAOYSA-N
InChi Code
InChI=1S/C4H11NO3/c5-4(1-6,2-7)3-8/h6-8H,1-3,5H2
Chemical Name
2-amino-2-(hydroxymethyl)propane-1,3-diol
Synonyms
Trometamol; TROMETHAMINE; 77-86-1; Tris(Hydroxymethyl)aminomethane; Tris; Tham; 2-Amino-2-(hydroxymethyl)propane-1,3-diol; Trisamine;
HS Tariff Code
2934.99.9001
Storage

Powder      -20°C    3 years

                     4°C     2 years

In solvent   -80°C    6 months

                  -20°C    1 month

Shipping Condition
Room temperature (This product is stable at ambient temperature for a few days during ordinary shipping and time spent in Customs)
Solubility Data
Solubility (In Vitro)
H2O : ~50 mg/mL (~412.75 mM)
DMSO : ~25 mg/mL (~206.37 mM)
Solubility (In Vivo)
Note: Listed below are some common formulations that may be used to formulate products with low water solubility (e.g. < 1 mg/mL), you may test these formulations using a minute amount of products to avoid loss of samples.

Injection Formulations
(e.g. IP/IV/IM/SC)
Injection Formulation 1: DMSO : Tween 80: Saline = 10 : 5 : 85 (i.e. 100 μL DMSO stock solution 50 μL Tween 80 850 μL Saline)
*Preparation of saline: Dissolve 0.9 g of sodium chloride in 100 mL ddH ₂ O to obtain a clear solution.
Injection Formulation 2: DMSO : PEG300Tween 80 : Saline = 10 : 40 : 5 : 45 (i.e. 100 μL DMSO 400 μLPEG300 50 μL Tween 80 450 μL Saline)
Injection Formulation 3: DMSO : Corn oil = 10 : 90 (i.e. 100 μL DMSO 900 μL Corn oil)
Example: Take the Injection Formulation 3 (DMSO : Corn oil = 10 : 90) as an example, if 1 mL of 2.5 mg/mL working solution is to be prepared, you can take 100 μL 25 mg/mL DMSO stock solution and add to 900 μL corn oil, mix well to obtain a clear or suspension solution (2.5 mg/mL, ready for use in animals).
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Injection Formulation 4: DMSO : 20% SBE-β-CD in saline = 10 : 90 [i.e. 100 μL DMSO 900 μL (20% SBE-β-CD in saline)]
*Preparation of 20% SBE-β-CD in Saline (4°C,1 week): Dissolve 2 g SBE-β-CD in 10 mL saline to obtain a clear solution.
Injection Formulation 5: 2-Hydroxypropyl-β-cyclodextrin : Saline = 50 : 50 (i.e. 500 μL 2-Hydroxypropyl-β-cyclodextrin 500 μL Saline)
Injection Formulation 6: DMSO : PEG300 : castor oil : Saline = 5 : 10 : 20 : 65 (i.e. 50 μL DMSO 100 μLPEG300 200 μL castor oil 650 μL Saline)
Injection Formulation 7: Ethanol : Cremophor : Saline = 10: 10 : 80 (i.e. 100 μL Ethanol 100 μL Cremophor 800 μL Saline)
Injection Formulation 8: Dissolve in Cremophor/Ethanol (50 : 50), then diluted by Saline
Injection Formulation 9: EtOH : Corn oil = 10 : 90 (i.e. 100 μL EtOH 900 μL Corn oil)
Injection Formulation 10: EtOH : PEG300Tween 80 : Saline = 10 : 40 : 5 : 45 (i.e. 100 μL EtOH 400 μLPEG300 50 μL Tween 80 450 μL Saline)


Oral Formulations
Oral Formulation 1: Suspend in 0.5% CMC Na (carboxymethylcellulose sodium)
Oral Formulation 2: Suspend in 0.5% Carboxymethyl cellulose
Example: Take the Oral Formulation 1 (Suspend in 0.5% CMC Na) as an example, if 100 mL of 2.5 mg/mL working solution is to be prepared, you can first prepare 0.5% CMC Na solution by measuring 0.5 g CMC Na and dissolve it in 100 mL ddH2O to obtain a clear solution; then add 250 mg of the product to 100 mL 0.5% CMC Na solution, to make the suspension solution (2.5 mg/mL, ready for use in animals).
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Oral Formulation 3: Dissolved in PEG400
Oral Formulation 4: Suspend in 0.2% Carboxymethyl cellulose
Oral Formulation 5: Dissolve in 0.25% Tween 80 and 0.5% Carboxymethyl cellulose
Oral Formulation 6: Mixing with food powders


Note: Please be aware that the above formulations are for reference only. InvivoChem strongly recommends customers to read literature methods/protocols carefully before determining which formulation you should use for in vivo studies, as different compounds have different solubility properties and have to be formulated differently.

 (Please use freshly prepared in vivo formulations for optimal results.)
Preparing Stock Solutions 1 mg 5 mg 10 mg
1 mM 8.2549 mL 41.2746 mL 82.5491 mL
5 mM 1.6510 mL 8.2549 mL 16.5098 mL
10 mM 0.8255 mL 4.1275 mL 8.2549 mL

*Note: Please select an appropriate solvent for the preparation of stock solution based on your experiment needs. For most products, DMSO can be used for preparing stock solutions (e.g. 5 mM, 10 mM, or 20 mM concentration); some products with high aqueous solubility may be dissolved in water directly. Solubility information is available at the above Solubility Data section. Once the stock solution is prepared, aliquot it to routine usage volumes and store at -20°C or -80°C. Avoid repeated freeze and thaw cycles.

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Working concentration mg/mL;

Method for preparing DMSO stock solution mg drug pre-dissolved in μL DMSO (stock solution concentration mg/mL). Please contact us first if the concentration exceeds the DMSO solubility of the batch of drug.

Method for preparing in vivo formulation:Take μL DMSO stock solution, next add μL PEG300, mix and clarify, next addμL Tween 80, mix and clarify, next add μL ddH2O,mix and clarify.

(1) Please be sure that the solution is clear before the addition of next solvent. Dissolution methods like vortex, ultrasound or warming and heat may be used to aid dissolving.
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Clinical Trial Information
Airway Alkalinization and Nasal Colonization
CTID: NCT03078088
Phase: Phase 1
Status: Completed
Date: 2020-03-30
Effects of Tromethamine on Cerebral Oxygenation and Metabolism in Patients Suffering Intractable Intracranial Hypertension – an exploratory study.
EudraCT: 2016-001863-35
Phase: Phase 4
Status: Prematurely Ended
Date: 2016-06-21
Influence of brain tissue pH regulation on cerebral oxygenation and metabolism in patients with severe traumatic brain injury.
EudraCT: 2005-000534-20
Phase: Phase 4
Status: Completed
Date: 2005-03-15
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