ObjectiveTo review available investigations describing the properties of the buffer mixture Tribonat[registered sign].Data SourcesOriginal reports published in peer-reviewed medical journals.Study SelectionReview of 76 citations, including four original studies on the effect of Tribonat performed by or supervised by the author, and six original studies concerning Tribonat originating from the institution to which the author is affiliated.Data ExtractionComputer search of the literature regarding treatment with alkaline buffers during cardiopulmonary resuscitation.Data SynthesisRoutine buffering of acidosis has been questioned, but clinical situations still exist where such treatment is regarded as indicated. In such cases, a buffer with advantageous qualities and few side-effects is desirable. The hitherto commonly used buffers do not always fulfill these requirements, and a more profound knowledge of the alternative Tribonat may therefore be warranted.ConclusionsThe reviewed articles support the assumption that Tribonat may offer important advantages over previously used buffers in situations where administration of an alkalinizing agent is indicated. (Crit Care Med 1999; 27:1009-1013)