Effects of intragastric sodium bicarbonate in infants with respiratory distress.

Stoneman, Margaret E. R.; Owens, Robert M.

doi:10.1136/adc.43.228.155

Cited by 6 publications

(2 citation statements)

References 7 publications

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“…Abraham and Brown (1967) found evidence that bicarbonate was well absorbed and corrected the pH as effectively as bicarbonate given intravenously. Stoneman and Owens (1968) found that though an accelerated recovery from metabolic acidosis could be achieved by giving intragastric sodium bicarbonate, there was little effect on rate of pH correction, for while in the untreated patient CO2 levels tended to fall, in the treated patients high CO, levels tended to be maintained.…”

Section: Discussionmentioning

confidence: 94%

Effects of Intragastric and Intravenous Sodium Bicarbonate on Rate of Recovery from Post-asphyxial Acidosis in the Neonate

Evans¹,

Olver²,

Appleyard³

et al. 1970

Archives of Disease in Childhood

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. (1970). Archives of Disease in Childhood, 45,321. Effects of intragastric and intravenous sodium bicarbonate on rate of recovery from post-asphyxial acidosis in the neonate. A trial was carried out on acidotic infants recovering from neonatal asphyxia, on the relative effects of intragastric and intravenous sodium bicarbonate on acid/base balance.Intragastric bicarbonate caused an increased rate of correction of metabolic acidosis within 30 minutes of administration. However, the Pco2 remained higher in these patients than in the controls, so that the effect of the bicarbonate on rate of pH correction was negligible. The rise in Pco, occurred despite apparently normal respiratory function.A similar limitation of pH rise by a sustained rise in Pco, was evident in the intravenously treated patients.Treatment of metabolic acidosis in neonates with sodium bicarbonate may not produce the desired correction of pH.Sodium bicarbonate is widely used in the treatment of neonatal acidosis, particularly in cases of asphyxia and respiratory distress syndrome (RDS). For these purposes it is usually given by the intravenous route, either by single injection or as an infusion. Dramatic clinical and biochemical improvement may follow its use in severely asphyxiated newborn infants. Since this response might be the result of changes either of a biochemical nature, or involving the pulmonary vasculature, we decided to measure the actual effect on acid-base metabolism of currently used doses of intravenous sodium bicarbonate.In 1967 Abraham and Brown suggested that in cases of RDS, bicarbonate given intragastrically was as effective in the correction of acidosis as bicarbonate given intravenously. We have followed up this observation with a trial of intragastric and intravenous bicarbonate given to acidotic infants recovering without complication from neonatal asphyxia. The trial was designed to show the relative rate and extent of correction achieved by the two routes. Material and MethodsObservations were carried out on newborn infants recovering from moderate to severe degrees of asphyxia as judged clinically. Infants who had required urgent alkali therapy during the resuscitation procedure were excluded from the trial. Also excluded were those infants showing any clinical evidence of impairment of pulmonary function during the recovery period, in order to minimize the possibility of inadequate oxygenation causing variations in the rate of spontaneous correction of acidosis.Those infants qualifying for the trial were randomly allocated treatment by a system of sealed envelopes and were given intravenous bicarbonate, intragastric bicarbonate, or intragastric water.Cases allocated to intravenous treatment were given sodium bicarbonate 1* 3 mEq/kg. injected over two minutes via an umbilical vein catheter. This dosage, though generally insufficient for full correction, may be safely used for emergency treatment of asphyxiated infants before acid-base measurements.

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Section: Discussionmentioning

confidence: 94%

Effects of Intragastric and Intravenous Sodium Bicarbonate on Rate of Recovery from Post-asphyxial Acidosis in the Neonate

Evans¹,

Olver²,

Appleyard³

et al. 1970

Archives of Disease in Childhood

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show abstract

“…Infants with respiratory distress syndrome given 5-8 mEq/kg of NaHC03 over 24 hours, did not manifest a change in PC02.39 Under similar circumstances, others have noted a mild to moderate increase in PC02. 40,41 The increase in PC02 could have been caused by alkali suppression of the respiratory drive and not from excessive C02 generation.…”

Section: G Increased Carbon Dioxide Productionmentioning

confidence: 99%

Alkali therapy of diabetic ketoacidosis: Biochemical, physiologic, and clinical perspectives

Riley

Cooper

Narins

1989

Diabetes Metab. Rev.

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Literatur

Helwig

1974

Anaesthesiology and Resuscitation / Anaesthesiologie Und Wiederbelebung / Anesthésiologie Et Réanimation

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Effects of intragastric sodium bicarbonate in infants with respiratory distress.

Cited by 6 publications

References 7 publications

Effects of Intragastric and Intravenous Sodium Bicarbonate on Rate of Recovery from Post-asphyxial Acidosis in the Neonate

Effects of Intragastric and Intravenous Sodium Bicarbonate on Rate of Recovery from Post-asphyxial Acidosis in the Neonate

Alkali therapy of diabetic ketoacidosis: Biochemical, physiologic, and clinical perspectives

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