Abstract
Recent studies suggest that NaHCO3 may be detrimental in treatment of cardiac arrest from ventricular fibrillation. The American Heart Association (AHA) recomnerds limited use of NaHCO3 (initial dose 1 mEq/kg). In children respiratory failure is the major cause of cardiac arrest; so these studies may not apply. The purpose of our study was to determine base deficit (-BE) at the time of cardiac arrest due to respiratory failure in immature pigs. 10 minipigs (8.0-9.5kg) were anesthetized with pentobarbital and ventilated. Catheters were placed in the aorta and pulmonary artery. The erdotracheal tubes were clamped (9.3±3.1 min) to produce asphyxia causing electromechanical dissociation (EMD) (Aortic pressure (PAo)<30 mmHg). (PAo), arterial blood gases and lactates were measured during a baseline (BL), at time of EMD and 3 min of EMD (EMD3)
All piglets developed metabolic acidosis that would require at least 6 mEq/kg of NaHCO3 for partial correction (-BEx Weight in kg x0.3). We conclude that cardiac arrest secondary to respiratory failure results in a -BE which is not treated with resuscitation practiced according to current AHA guidelines.
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Jefferson, L., Fisher, D., Rosborough, J. et al. BASE DEFICIT DURING CITEIPC ARREST SECONDARY TO RESPIRATORY FAILURE IN IMMATURE PIGS. Pediatr Res 21 (Suppl 4), 201 (1987). https://doi.org/10.1203/00006450-198704010-00211
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DOI: https://doi.org/10.1203/00006450-198704010-00211