Journal article
Sodium Bicarbonate for the Treatment of Lactic Acidosis
Chest, Vol.117(1), pp.260-267
01/2000
DOI: 10.1378/chest.117.1.260
PMID: 10631227
Abstract
Lactic acidosis often challenges the intensivist and is associatedwith a strikingly high mortality. Treatment involves discerning andcorrecting its underlying cause, ensuring adequate oxygen delivery totissues, reducing oxygen demand through sedation and mechanicalventilation, and (most controversially) attempting to alkalinize theblood with IV sodium bicarbonate. Here we review the literature toanswer the following questions: Is a low pH bad? Can sodium bicarbonateraise the pH in vivo? Does increasing the blood pH withsodium bicarbonate have any salutary effects? Does sodium bicarbonatehave negative side effects? We find that the oft-cited rationale forbicarbonate use, that it might ameliorate the hemodynamic depression ofmetabolic acidemia, has been disproved convincingly. Further, given thelack of evidence supporting its use, we cannot condone bicarbonateadministration for patients with lactic acidosis, regardless of thedegree of acidemia.
Details
- Title: Subtitle
- Sodium Bicarbonate for the Treatment of Lactic Acidosis
- Creators
- Sean M Forsythe - Department of Medicine, University of Chicago School of Medicine, Chicago, ILGregory A Schmidt - Section of Pulmonary and Critical Care, University of Chicago School of Medicine, Chicago, IL
- Resource Type
- Journal article
- Publication Details
- Chest, Vol.117(1), pp.260-267
- Publisher
- Elsevier Inc
- DOI
- 10.1378/chest.117.1.260
- PMID
- 10631227
- ISSN
- 0012-3692
- eISSN
- 1931-3543
- Language
- English
- Date published
- 01/2000
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; Internal Medicine
- Record Identifier
- 9984094730702771
Metrics
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