Hemodynamic effects of sodium bicarbonate in critically ill neonates
To analyze the cardiovascular effects of sodium bicarbonate in neonates with metabolic acidosis. Prospective, open, non-randomized, before-after intervention study with hemodynamic measurements performed before and 1, 5, 10, 20, and 30 min after bicarbonate administration. Neonatal intensive care un...
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| Veröffentlicht in: | Intensive care medicine 1993-02, Vol.19 (2), p.65-69 |
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| creator | FANCONI, S BURGER, R GHELFI, D UEHLINGER, J ARBENZ, U |
| description | To analyze the cardiovascular effects of sodium bicarbonate in neonates with metabolic acidosis.
Prospective, open, non-randomized, before-after intervention study with hemodynamic measurements performed before and 1, 5, 10, 20, and 30 min after bicarbonate administration.
Neonatal intensive care unit, tertiary care center.
Sequential sample of 16 paralysed and mechanically ventilated newborn infants with a metabolic acidosis (pH < 7.25 in premature and < 7.30 in term infants, base deficit > -8).
An 8.4% sodium bicarbonate solution diluted 1:1 with water (final osmolality of 1000 mOsm/l) was administered in two equal portions at a rate of 0.5 mmol/min. The dose in mmol was calculated using the formula "base deficit x body weight (kg) x 1/3 x 1/2".
Sodium bicarbonate induced a significant but transient rise in pulsed Doppler cardiac output (CO) (+27.7%), aortic blood flow velocity (+15.3%), systolic blood pressure (BP) (+9.3%), (+14.6%), transcutaneous carbon dioxide pressure (PtcCO2) (+11.8%), and transcutaneous oxygen pressure (PtcO2) (+8%). In spite of the PaCO2 elevation, pH significantly improved (from a mean of 7.24 to 7.30), and the base deficit decreased (-39.3%). Calculated systemic vascular resistance (SVR) (-10.7%) and diastolic BP (-11.7%) decreased significantly, while PaO2 and heart rate (HR) did not change. Central venous pressure (CVP) (+6.5%) increased only slightly. By 30 min after bicarbonate administration all hemodynamic parameters, with the exception of the diastolic BP, had returned to baseline.
Sodium bicarbonate in neonates with metabolic acidosis induces an increase in contractility and a reduction in afterload. |
| doi_str_mv | 10.1007/BF01708362 |
| format | Article |
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Prospective, open, non-randomized, before-after intervention study with hemodynamic measurements performed before and 1, 5, 10, 20, and 30 min after bicarbonate administration.
Neonatal intensive care unit, tertiary care center.
Sequential sample of 16 paralysed and mechanically ventilated newborn infants with a metabolic acidosis (pH < 7.25 in premature and < 7.30 in term infants, base deficit > -8).
An 8.4% sodium bicarbonate solution diluted 1:1 with water (final osmolality of 1000 mOsm/l) was administered in two equal portions at a rate of 0.5 mmol/min. The dose in mmol was calculated using the formula "base deficit x body weight (kg) x 1/3 x 1/2".
Sodium bicarbonate induced a significant but transient rise in pulsed Doppler cardiac output (CO) (+27.7%), aortic blood flow velocity (+15.3%), systolic blood pressure (BP) (+9.3%), (+14.6%), transcutaneous carbon dioxide pressure (PtcCO2) (+11.8%), and transcutaneous oxygen pressure (PtcO2) (+8%). In spite of the PaCO2 elevation, pH significantly improved (from a mean of 7.24 to 7.30), and the base deficit decreased (-39.3%). Calculated systemic vascular resistance (SVR) (-10.7%) and diastolic BP (-11.7%) decreased significantly, while PaO2 and heart rate (HR) did not change. Central venous pressure (CVP) (+6.5%) increased only slightly. By 30 min after bicarbonate administration all hemodynamic parameters, with the exception of the diastolic BP, had returned to baseline.
Sodium bicarbonate in neonates with metabolic acidosis induces an increase in contractility and a reduction in afterload.</description><identifier>ISSN: 0342-4642</identifier><identifier>EISSN: 1432-1238</identifier><identifier>DOI: 10.1007/BF01708362</identifier><identifier>PMID: 8387554</identifier><identifier>CODEN: ICMED9</identifier><language>eng</language><publisher>Heidelberg: Springer</publisher><subject>Acidosis, Lactic - diagnosis ; Acidosis, Lactic - drug therapy ; Acidosis, Lactic - physiopathology ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Bicarbonates - administration & dosage ; Bicarbonates - pharmacology ; Bicarbonates - therapeutic use ; Biological and medical sciences ; Birth Weight ; Blood Gas Analysis ; Blood Gas Monitoring, Transcutaneous ; Critical Illness ; Echocardiography, Doppler ; Emergency and intensive care: neonates and children. Prematurity. Sudden death ; Gestational Age ; Hemodynamics - drug effects ; Humans ; Infant, Newborn ; Infant, Premature ; Infusions, Intravenous ; Intensive care medicine ; Intensive Care Units, Neonatal ; Medical sciences ; Myocardial Contraction - drug effects ; Prospective Studies ; Respiration, Artificial ; Sodium - administration & dosage ; Sodium - pharmacology ; Sodium - therapeutic use ; Sodium Bicarbonate</subject><ispartof>Intensive care medicine, 1993-02, Vol.19 (2), p.65-69</ispartof><rights>1993 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c311t-e8c95cf208575a7486fe9729d39aaa9b431081a074c69e5f7c5fe95e59ae06423</citedby><cites>FETCH-LOGICAL-c311t-e8c95cf208575a7486fe9729d39aaa9b431081a074c69e5f7c5fe95e59ae06423</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=4624846$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8387554$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>FANCONI, S</creatorcontrib><creatorcontrib>BURGER, R</creatorcontrib><creatorcontrib>GHELFI, D</creatorcontrib><creatorcontrib>UEHLINGER, J</creatorcontrib><creatorcontrib>ARBENZ, U</creatorcontrib><title>Hemodynamic effects of sodium bicarbonate in critically ill neonates</title><title>Intensive care medicine</title><addtitle>Intensive Care Med</addtitle><description>To analyze the cardiovascular effects of sodium bicarbonate in neonates with metabolic acidosis.
Prospective, open, non-randomized, before-after intervention study with hemodynamic measurements performed before and 1, 5, 10, 20, and 30 min after bicarbonate administration.
Neonatal intensive care unit, tertiary care center.
Sequential sample of 16 paralysed and mechanically ventilated newborn infants with a metabolic acidosis (pH < 7.25 in premature and < 7.30 in term infants, base deficit > -8).
An 8.4% sodium bicarbonate solution diluted 1:1 with water (final osmolality of 1000 mOsm/l) was administered in two equal portions at a rate of 0.5 mmol/min. The dose in mmol was calculated using the formula "base deficit x body weight (kg) x 1/3 x 1/2".
Sodium bicarbonate induced a significant but transient rise in pulsed Doppler cardiac output (CO) (+27.7%), aortic blood flow velocity (+15.3%), systolic blood pressure (BP) (+9.3%), (+14.6%), transcutaneous carbon dioxide pressure (PtcCO2) (+11.8%), and transcutaneous oxygen pressure (PtcO2) (+8%). In spite of the PaCO2 elevation, pH significantly improved (from a mean of 7.24 to 7.30), and the base deficit decreased (-39.3%). Calculated systemic vascular resistance (SVR) (-10.7%) and diastolic BP (-11.7%) decreased significantly, while PaO2 and heart rate (HR) did not change. Central venous pressure (CVP) (+6.5%) increased only slightly. By 30 min after bicarbonate administration all hemodynamic parameters, with the exception of the diastolic BP, had returned to baseline.
Sodium bicarbonate in neonates with metabolic acidosis induces an increase in contractility and a reduction in afterload.</description><subject>Acidosis, Lactic - diagnosis</subject><subject>Acidosis, Lactic - drug therapy</subject><subject>Acidosis, Lactic - physiopathology</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Bicarbonates - administration & dosage</subject><subject>Bicarbonates - pharmacology</subject><subject>Bicarbonates - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Birth Weight</subject><subject>Blood Gas Analysis</subject><subject>Blood Gas Monitoring, Transcutaneous</subject><subject>Critical Illness</subject><subject>Echocardiography, Doppler</subject><subject>Emergency and intensive care: neonates and children. Prematurity. Sudden death</subject><subject>Gestational Age</subject><subject>Hemodynamics - drug effects</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Infant, Premature</subject><subject>Infusions, Intravenous</subject><subject>Intensive care medicine</subject><subject>Intensive Care Units, Neonatal</subject><subject>Medical sciences</subject><subject>Myocardial Contraction - drug effects</subject><subject>Prospective Studies</subject><subject>Respiration, Artificial</subject><subject>Sodium - administration & dosage</subject><subject>Sodium - pharmacology</subject><subject>Sodium - therapeutic use</subject><subject>Sodium Bicarbonate</subject><issn>0342-4642</issn><issn>1432-1238</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1993</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkM1LAzEUxIMotVYv3oUcxIOwms9N9qjVWqHgRc9LNvsCkf2oye6h_72pXerpwcyP4c0gdE3JAyVEPT6vCFVE85ydoDkVnGWUcX2K5oQLlolcsHN0EeM3SVgu6QzNNNdKSjFHL2to-3rXmdZbDM6BHSLuHY597ccWV96aUPWdGQD7Dtvgh6Q0zQ77psEd_DnxEp0500S4mu4Cfa1eP5frbPPx9r582mSWUzpkoG0hrWNESyWNEjp3UChW1LwwxhSV4JRoaogSNi9AOmVlAiTIwgBJJfgC3R1yt6H_GSEOZeujhaYx6ZMxlkoqpiTdg_cH0IY-xgCu3AbfmrArKSn3k5X_kyX4ZkodqxbqIzptlPzbyTcxdXfBdNbHIyZyJrTI-S9Ey3Hx</recordid><startdate>199302</startdate><enddate>199302</enddate><creator>FANCONI, S</creator><creator>BURGER, R</creator><creator>GHELFI, D</creator><creator>UEHLINGER, J</creator><creator>ARBENZ, U</creator><general>Springer</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>199302</creationdate><title>Hemodynamic effects of sodium bicarbonate in critically ill neonates</title><author>FANCONI, S ; BURGER, R ; GHELFI, D ; UEHLINGER, J ; ARBENZ, U</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c311t-e8c95cf208575a7486fe9729d39aaa9b431081a074c69e5f7c5fe95e59ae06423</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1993</creationdate><topic>Acidosis, Lactic - diagnosis</topic><topic>Acidosis, Lactic - drug therapy</topic><topic>Acidosis, Lactic - physiopathology</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Bicarbonates - administration & dosage</topic><topic>Bicarbonates - pharmacology</topic><topic>Bicarbonates - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Birth Weight</topic><topic>Blood Gas Analysis</topic><topic>Blood Gas Monitoring, Transcutaneous</topic><topic>Critical Illness</topic><topic>Echocardiography, Doppler</topic><topic>Emergency and intensive care: neonates and children. Prematurity. Sudden death</topic><topic>Gestational Age</topic><topic>Hemodynamics - drug effects</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Infant, Premature</topic><topic>Infusions, Intravenous</topic><topic>Intensive care medicine</topic><topic>Intensive Care Units, Neonatal</topic><topic>Medical sciences</topic><topic>Myocardial Contraction - drug effects</topic><topic>Prospective Studies</topic><topic>Respiration, Artificial</topic><topic>Sodium - administration & dosage</topic><topic>Sodium - pharmacology</topic><topic>Sodium - therapeutic use</topic><topic>Sodium Bicarbonate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>FANCONI, S</creatorcontrib><creatorcontrib>BURGER, R</creatorcontrib><creatorcontrib>GHELFI, D</creatorcontrib><creatorcontrib>UEHLINGER, J</creatorcontrib><creatorcontrib>ARBENZ, U</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Intensive care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>FANCONI, S</au><au>BURGER, R</au><au>GHELFI, D</au><au>UEHLINGER, J</au><au>ARBENZ, U</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hemodynamic effects of sodium bicarbonate in critically ill neonates</atitle><jtitle>Intensive care medicine</jtitle><addtitle>Intensive Care Med</addtitle><date>1993-02</date><risdate>1993</risdate><volume>19</volume><issue>2</issue><spage>65</spage><epage>69</epage><pages>65-69</pages><issn>0342-4642</issn><eissn>1432-1238</eissn><coden>ICMED9</coden><abstract>To analyze the cardiovascular effects of sodium bicarbonate in neonates with metabolic acidosis.
Prospective, open, non-randomized, before-after intervention study with hemodynamic measurements performed before and 1, 5, 10, 20, and 30 min after bicarbonate administration.
Neonatal intensive care unit, tertiary care center.
Sequential sample of 16 paralysed and mechanically ventilated newborn infants with a metabolic acidosis (pH < 7.25 in premature and < 7.30 in term infants, base deficit > -8).
An 8.4% sodium bicarbonate solution diluted 1:1 with water (final osmolality of 1000 mOsm/l) was administered in two equal portions at a rate of 0.5 mmol/min. The dose in mmol was calculated using the formula "base deficit x body weight (kg) x 1/3 x 1/2".
Sodium bicarbonate induced a significant but transient rise in pulsed Doppler cardiac output (CO) (+27.7%), aortic blood flow velocity (+15.3%), systolic blood pressure (BP) (+9.3%), (+14.6%), transcutaneous carbon dioxide pressure (PtcCO2) (+11.8%), and transcutaneous oxygen pressure (PtcO2) (+8%). In spite of the PaCO2 elevation, pH significantly improved (from a mean of 7.24 to 7.30), and the base deficit decreased (-39.3%). Calculated systemic vascular resistance (SVR) (-10.7%) and diastolic BP (-11.7%) decreased significantly, while PaO2 and heart rate (HR) did not change. Central venous pressure (CVP) (+6.5%) increased only slightly. By 30 min after bicarbonate administration all hemodynamic parameters, with the exception of the diastolic BP, had returned to baseline.
Sodium bicarbonate in neonates with metabolic acidosis induces an increase in contractility and a reduction in afterload.</abstract><cop>Heidelberg</cop><cop>Berlin</cop><pub>Springer</pub><pmid>8387554</pmid><doi>10.1007/BF01708362</doi><tpages>5</tpages></addata></record> |
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| ispartof | Intensive care medicine, 1993-02, Vol.19 (2), p.65-69 |
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| subjects | Acidosis, Lactic - diagnosis Acidosis, Lactic - drug therapy Acidosis, Lactic - physiopathology Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Bicarbonates - administration & dosage Bicarbonates - pharmacology Bicarbonates - therapeutic use Biological and medical sciences Birth Weight Blood Gas Analysis Blood Gas Monitoring, Transcutaneous Critical Illness Echocardiography, Doppler Emergency and intensive care: neonates and children. Prematurity. Sudden death Gestational Age Hemodynamics - drug effects Humans Infant, Newborn Infant, Premature Infusions, Intravenous Intensive care medicine Intensive Care Units, Neonatal Medical sciences Myocardial Contraction - drug effects Prospective Studies Respiration, Artificial Sodium - administration & dosage Sodium - pharmacology Sodium - therapeutic use Sodium Bicarbonate |
| title | Hemodynamic effects of sodium bicarbonate in critically ill neonates |
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