Lactate versus bicarbonate

Schwartz, William B.; Waters, W G

doi:10.1016/0002-9343(62)90029-3

Cited by 51 publications

(11 citation statements)

References 13 publications

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“…Lac has been traditionally accepted as the best replacement for bicarbonate in the treatment of metabolic acidosis since early 1930s [7]; it has since become part of solutions for dialysis and continuous renal replacement therapy for several decades.…”

Section: Lactate Metabolism and Effects On Phi And Lactic Acidosismentioning

confidence: 99%

Pyruvate in the Correction of Intracellular Acidosis: A Metabolic Basis as a Novel Superior Buffer

Zhou¹

2005

Am J Nephrol

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The review focuses on biochemical metabolisms of conventional buffers and emphasizes advantages of sodium pyruvate (Pyr) in the correction of intracellular acidosis. Exogenous lactate (Lac) as an alternative of natural buffer, bicarbonate, consumes intracellular protons on an equimolar basis, regenerating bicarbonate anions in plasma while the completion of gluconeogenesis and/or oxidation occurs via tricarboxylic-acid cycle in mitochondria mainly in liver and kidney, or heart. The general assumption that Lac is ‘metabolized to bicarbonate’ in liver to serve as a buffer has been questioned. Pyr as a novel buffer would be superior to conventional ones in the correction of metabolic acidosis. Several likely biochemical mechanisms of Pyr action are discussed. Experimental evidence, in vivo, strongly suggested that Pyr would be particularly efficient in the correction of severe acidemia: type A lactic acidosis, hypercapnia with cardiac arrest, and diabetic and alcoholic ketoacidosis in animal experiments and clinic settings. Because of its multi-cytoprotection, Pyrs not only correct acidosis, but also benefit theunderlying dysfunction of vital organs. In addition, Pyr is also a potential buffer component of dialysis solutions. However, the instability of Pyr in aqueous solutions restricts its clinical applications as a therapeutic agent. Attempts to create a stable Pyr preparation are needed.

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Section: Lactate Metabolism and Effects On Phi And Lactic Acidosismentioning

confidence: 99%

Pyruvate in the Correction of Intracellular Acidosis: A Metabolic Basis as a Novel Superior Buffer

Zhou¹

2005

Am J Nephrol

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“…The alkalising effect of sodium lactate de pends on its metabolism to carbon dioxide, and sodium bicarbonate is therefore prefera ble in diseases where lactate metabolism may be impaired [Schwartz and Waters, 1962], However, pharmaceutical and storage considerations make lactate a more conve nient anion in solutions for peritoneal dialy sis. At present these preparations contain so dium D(-)L(+)-lactate, but the pure L(+)-isomer would be preferable.…”

Section: The Renal Excretion O F Lactate Enantiomersmentioning

confidence: 99%

Comparison of the Kinetics and Utilisation of <i>D</i>(-)- and <i>L</i>(+)-Sodium Lactate in Normal Man

1983

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After infusion of sodium D(-)L(+)-lactate in healthy man the clearance of the D(-)-isomer from blood was 70% of that of the L(+)-isomer. Utilisation of L(+)-lactate may have been inhibited by the presence of the D(-)-isomer. The changes in blood pyruvate concentration and ketone body ratio were compatible with mitochondrial oxidation of D(-)-lactate to pyruvate. After infusion of a D(-)L(+)-lactate racemic mixture, the renal excretion of the D(-)-isomer was much greater than that of the L(+)-isomer, although peak blood concentrations of the L(+) were higher than those of the D(-)-isomer. After infusion of sodium L(+)-lactate, the renal excretion of D(-)-lactate increased 7 times, although no D(-)-lactate could be detected in the blood or in the sodium L(+)-lactate infused.

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“…There was, however, n o significant change in pH, BE or bicarbonate following infusion of these solutions. Metabolism of lactate t o bicarbonate is said to require 1-2 h (Schwartz & Waters, 1962). However, the stable pH at the end of the infusion of Hartmann's solution, wauld appear to indicate that metabolism of lactate t o bicarbonate was taking place during the course of infusion.…”

Section: (B) Blood-gas and Acid-base Balancementioning

confidence: 99%

Some physiological and biochemical effects of the intravenous administration of five different electrolyte solutions in the dog

Rose

1979

Vet Pharm & Therapeutics

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Rose, R. J. Some physiological and biochemical effects of the intravenous administration of five different electrolyte solutions in the dog. 1. vet. Pharnacol. Therap. 2, 279-289, 1979.Some physiological effects of the intravenous administration of five different commercial electrolyte solutions were studied in healthy conscious dogs. Measurements were taken before, during and up to 3 h after fluid administration. The measurements included temperature, heart rate, respiratory rate, systolic and diastolic arterial pressure, central venous pressure, p02, pC02, pH, packed cell volume, haemoglobin, total plasma protein, sodium, potassium, chloride, bicarbonate, base excess and creatinine. There were no significant changes in temperature, respiratory rate, systolic pressure, p 0 2 or pCOz. All dogs showed a similar rise in central venous pressure and a fall in packed cell volume, haemoglobin and total plasma protein in response t o the fluid administration. Two saline solutions produced a metabolic acidosis, a fall in plasma potassium values and a rise in chloride. Administration of multi-electrolyte solutions resulted in the least disturbance in acid-base and electrolyte balance.

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Lactate versus bicarbonate

Cited by 51 publications

References 13 publications

Pyruvate in the Correction of Intracellular Acidosis: A Metabolic Basis as a Novel Superior Buffer

Pyruvate in the Correction of Intracellular Acidosis: A Metabolic Basis as a Novel Superior Buffer

Comparison of the Kinetics and Utilisation of <i>D</i>(-)- and <i>L</i>(+)-Sodium Lactate in Normal Man

Some physiological and biochemical effects of the intravenous administration of five different electrolyte solutions in the dog

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