Mathematical modeling of buffers used in myocardial preservation

Triana, Jonathan R.; Yanagihashi, Mark; Larson, Douglas F.
September 2007
Perfusion;Sep2007, Vol. 22 Issue 5, p353
Academic Journal
Objective. Buffers added to myocardial preservation solutions are considered to be critical for resisting myocardium pH changes from the accumulation of protons (H(sup+]). Our hypothesis is that mathematical modeling of three clinically used buffers will define their individual buffering capacities under simulated clinical conditions. Methods. The buffers, tromethamine (THAM), sodium bicarbonate (HCO[sub3][sup-]), and L-histidine, were compared in terms of their buffering capacity (β) under specific temperatures and concentrations, using a mathematical model. Results. At 37°C, the maximal beta (β[submax]) occurred at pH 7.75 for THAM, pH 6.10 for HCO[sub3[sup-], and pH 5.89 for L-histidine at equimolar concentrations. A decrease in temperature moved β[submax] to a higher pH value for each buffer. At clinical concentrations, L-histidine provided the greatest buffering capacity followed by HCO[sub3[sup-] and THAM, respectively. Discussion. This model permitted comparison of the above buffers under simulated clinical conditions. The assumption was that the magnitude of β[submax] at a given temperature determines which buffer(s) could be most effective for myocardial preservation. Also, the assumption was taken that these buffers are used in a closed system - where there is no continuous blood flow - and that the buffering ability of THAM and L-histidine were not influenced by the accumulation of CO[sub2] as is HCO[sub3[sup-]. THAM and L-histidine were more effective at hypothermic temperatures compared with HCO[sub3[sup-]; however, HCO[sub3[sup-] provided buffering at normothermic temperatures. Through the theoretical considerations of this study, we propose that combining HCO[sub3[sup-] with THAM or L-histidine could be most efficacious for myocardial preservation during open heart surgery or organ transplantation.


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