Abstract
The buffering reserve of mildly distressed term neonates was studied in 15 tachypneic babies with a clinically suspected aspiration syndrome, 8 of whom received HCO3 therapy (Rx+) and 7 of whom did not (Rx−). Both groups had mean 1-min Apgar scores <5 and remained more tachypneic than controls (CON, N=17) during Days 1-4 of life. There were no differences in wt loss, birth wt, gestational age or O2 requirement among the 3 groups and there was no difference in respiratory rate between Rx+ and Rx−.
(See TABLE) Rx+ had a lower Day 1 pH than Rx− (p<0.05) or CON (p<0.01) but had corrected to normal by Day 2. On Day 2 Rx− had a higher pH than CON (p<0.05). This relative alkalosis in Rx− can in part be explained by Day 1 respiratory compensation, when PCO2 for Rx− is >CON (p<0.001 and <Rx+ (p<0.02). This compensation was augmented by endogenous generation of HCO3 (ΔHCO3=wt × 0.6[lowest Day 2 serum HCO3 - lowest Day 1 serum HCO3] - HCO3 therapy). Rx− ΔHCO3 was >CON (p<0.01) and Rx+ ΔHCO3 was also >CON but not statistically significant.
These tachypneic term neonates generated a mean of 2-3 mEq/kg HCO3 during the first day of life. Intravenous HCO3 in the treatment of similar babies may thus be unnecessary.
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Brown, D., Swenson, B., Holzman, I. et al. 940 RELATIVE ALKALOSIS IN MILDLY DISTRESSED TERM NEONATES. Pediatr Res 12 (Suppl 4), 520 (1978). https://doi.org/10.1203/00006450-197804001-00946
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DOI: https://doi.org/10.1203/00006450-197804001-00946