Abstract
Recent studies have questioned the administration of sodium bicarbonate (SB) to critically ill patients because of negative hemodynamic effects.
We studied 16 paralyzed and normoventilated neonates (mean age 33.5 weeks) with metabolic acidosis (base excess < -8). Hemodynamic and blood gas data were measured before, 1, 5, 10, 20, and 30 minutes after SB.
SB induced a rapid and significant rise in pulsed Doppler cardiac output (+27.7%), aortic blood flow velocity (+-15.3%), systolic BP ( + 9.3%), base excess (+39.3%), PaCO2 (+14.6%), tcPCO2 (+11.8%), and tcPO2 (+8%). In spite of the PaCO2 elevation, pH significantly improved (from a mean of 7.24 to 7.30). Calculated systemic vascular resistance (-10.7%) and diastolic BP (-11.7%) decreased significantly, while PaO2 (-4.9%) and heart rate (+2.5%) did not change. Central venous pressure (+6.5%) increased slightly.
Our data indicate that SB improves cardiac output through a reduction in systemic vascular resistance, and an increase in contractility and in preload.
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Fanconi, S., Burger, R., Ghelfi, D. et al. 33 HEMODYNAMIC EFFECTS OF SODIUM BICARBONATE IN NEONATES. Pediatr Res 30, 633 (1991). https://doi.org/10.1203/00006450-199112000-00063
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DOI: https://doi.org/10.1203/00006450-199112000-00063