Base administration or fluid bolus for preventing morbidity and mortality in preterm infants with metabolic acidosis
Background Metabolic acidosis in the early newborn period is associated with adverse outcomes in preterm infants. The most commonly used strategies to correct metabolic acidosis are intravascular infusion of base, for example sodium bicarbonate, and intravascular infusion of a fluid bolus, usually a...
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| creator | Lawn, Cassie J Weir, Fiona J McGuire, William Lawn, Cassie J |
| description | Background
Metabolic acidosis in the early newborn period is associated with adverse outcomes in preterm infants. The most commonly used strategies to correct metabolic acidosis are intravascular infusion of base, for example sodium bicarbonate, and intravascular infusion of a fluid bolus, usually a crystalloid or colloid solution.
Objectives
To determine the effect of either infusion of base or of a fluid bolus on mortality and adverse neurodevelopmental outcomes in preterm infants with metabolic acidosis.
Search methods
We used the standard search strategy of the Cochrane Neonatal Review Group. This included searches of the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1, 2005), MEDLINE (1966 to January 2005), EMBASE (1980 to January 2005), CINAHL (1982 to January 2005).
The search was updated in 2010.
Selection criteria
Randomised or quasi‐randomised controlled trials that evaluated the following treatments for preterm infants with metabolic acidosis:
1. Infusion of base versus no treatment;
2. Infusion of fluid bolus versus no treatment;
3. Infusion of base versus fluid bolus.
Data collection and analysis
We extracted the data using the standard methods of the Cochrane Neonatal Review Group with separate evaluation of trial quality and data extraction by two review authors, and synthesis of data using relative risk and risk difference.
Main results
We found two small randomised controlled trails that fulfilled the eligibility criteria (Corbet 1977; Dixon 1999) and one unpublished pilot trial (Lawn 2005). Corbet 1977 compared treating infants with sodium bicarbonate infusion (N = 30) versus no treatment (N = 32) and did not find evidence of an effect on mortality [relative risk (RR) 1.39 (95% confidence interval 0.72 to 2.67)] or in the incidence of intra/periventricular haemorrhage [RR 1.24 (95% confidence interval 0.47 to 3.28)]. Addition of the unpublished data of Lawn 2005 does not change the overall estimate of effect on mortality [typical RR 1.45 (95%CI 0.82 to 2.56)]. Dixon 1999 compared treatment with sodium bicarbonate (N = 16) versus fluid bolus (N = 20). The primary outcome assessed was arterial blood pH/base excess two hours after the intervention. Other clinical outcomes were not reported. Neither trial assessed longer term neurodevelopmental outcomes.
Authors' conclusions
There is insufficient evidence from randomised controlled trials to determine whether infusion of base or fluid bolus reduc |
| doi_str_mv | 10.1002/14651858.CD003215.pub2 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8711593</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>67766513</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3862-6d503f776adb890c403a445882dd4872170f8919561c73ec2ee7a96c1b8a42e33</originalsourceid><addsrcrecordid>eNqFUU1v3CAQRVWq5qP9CxGn3HYD2Mb4UinZ5kuK1Et7RmPAWSobNoAT7b8vaDdtkktOzOi9eW-Yh9ApJUtKCDunNW-oaMRy9YOQitFmuZl79gkdFWBRkINX9SE6jvFPJvKOtV_QIW1EzbPAEUqXEA0GPVlnYwqQrHfYBzyMs9W49-Mc8ZD7TTBPxiXrHvDkQ2-1TVsMTpcuwVg66wormTDlcgCXIn62aY0nkyALWYVBWe2jjV_R5wHGaL7t3xP0-_rq1-p2cf_z5m51cb9QleBswXVDqqFtOehedETVpIK6boRgWteiZbQlg-ho13Cq2sooZkwLHVe0F1AzU1Un6PtON99mMlrlDwQY5SbYCcJWerDyLeLsWj74JylaSpuuCJztBYJ_nE1McrJRmXEEZ_wcJc_L5TMWIt8RVfAxBjP8M6FElsDkS2DyJbBizfLg6esV_4_tE8qEyx3h2Y5mK5VX65DdP9B95_IXTO6pYQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>67766513</pqid></control><display><type>article</type><title>Base administration or fluid bolus for preventing morbidity and mortality in preterm infants with metabolic acidosis</title><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Lawn, Cassie J ; Weir, Fiona J ; McGuire, William ; Lawn, Cassie J</creator><creatorcontrib>Lawn, Cassie J ; Weir, Fiona J ; McGuire, William ; Lawn, Cassie J</creatorcontrib><description>Background
Metabolic acidosis in the early newborn period is associated with adverse outcomes in preterm infants. The most commonly used strategies to correct metabolic acidosis are intravascular infusion of base, for example sodium bicarbonate, and intravascular infusion of a fluid bolus, usually a crystalloid or colloid solution.
Objectives
To determine the effect of either infusion of base or of a fluid bolus on mortality and adverse neurodevelopmental outcomes in preterm infants with metabolic acidosis.
Search methods
We used the standard search strategy of the Cochrane Neonatal Review Group. This included searches of the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1, 2005), MEDLINE (1966 to January 2005), EMBASE (1980 to January 2005), CINAHL (1982 to January 2005).
The search was updated in 2010.
Selection criteria
Randomised or quasi‐randomised controlled trials that evaluated the following treatments for preterm infants with metabolic acidosis:
1. Infusion of base versus no treatment;
2. Infusion of fluid bolus versus no treatment;
3. Infusion of base versus fluid bolus.
Data collection and analysis
We extracted the data using the standard methods of the Cochrane Neonatal Review Group with separate evaluation of trial quality and data extraction by two review authors, and synthesis of data using relative risk and risk difference.
Main results
We found two small randomised controlled trails that fulfilled the eligibility criteria (Corbet 1977; Dixon 1999) and one unpublished pilot trial (Lawn 2005). Corbet 1977 compared treating infants with sodium bicarbonate infusion (N = 30) versus no treatment (N = 32) and did not find evidence of an effect on mortality [relative risk (RR) 1.39 (95% confidence interval 0.72 to 2.67)] or in the incidence of intra/periventricular haemorrhage [RR 1.24 (95% confidence interval 0.47 to 3.28)]. Addition of the unpublished data of Lawn 2005 does not change the overall estimate of effect on mortality [typical RR 1.45 (95%CI 0.82 to 2.56)]. Dixon 1999 compared treatment with sodium bicarbonate (N = 16) versus fluid bolus (N = 20). The primary outcome assessed was arterial blood pH/base excess two hours after the intervention. Other clinical outcomes were not reported. Neither trial assessed longer term neurodevelopmental outcomes.
Authors' conclusions
There is insufficient evidence from randomised controlled trials to determine whether infusion of base or fluid bolus reduces morbidity and mortality in preterm infants with metabolic acidosis. Further large randomised trials are needed.</description><identifier>ISSN: 1465-1858</identifier><identifier>ISSN: 1469-493X</identifier><identifier>EISSN: 1465-1858</identifier><identifier>EISSN: 1469-493X</identifier><identifier>DOI: 10.1002/14651858.CD003215.pub2</identifier><identifier>PMID: 15846651</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Acidosis ; Acidosis - complications ; Acidosis - drug therapy ; Acidosis - mortality ; Buffers ; Child health ; Fluid Therapy ; Fluid Therapy - methods ; Fluid, Electrolytes, and Acid‐Base Homeostasis ; Humans ; Immediate care of the newborn ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases ; Infant, Premature, Diseases - drug therapy ; Infant, Premature, Diseases - mortality ; Medicine General & Introductory Medical Sciences ; Neonatal care ; Randomized Controlled Trials as Topic ; Sodium Bicarbonate ; Sodium Bicarbonate - administration & dosage ; Tromethamine ; Tromethamine - administration & dosage</subject><ispartof>Cochrane database of systematic reviews, 2005-04, Vol.2010 (11), p.CD003215</ispartof><rights>Copyright © 2010 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3862-6d503f776adb890c403a445882dd4872170f8919561c73ec2ee7a96c1b8a42e33</citedby><cites>FETCH-LOGICAL-c3862-6d503f776adb890c403a445882dd4872170f8919561c73ec2ee7a96c1b8a42e33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15846651$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lawn, Cassie J</creatorcontrib><creatorcontrib>Weir, Fiona J</creatorcontrib><creatorcontrib>McGuire, William</creatorcontrib><creatorcontrib>Lawn, Cassie J</creatorcontrib><title>Base administration or fluid bolus for preventing morbidity and mortality in preterm infants with metabolic acidosis</title><title>Cochrane database of systematic reviews</title><addtitle>Cochrane Database Syst Rev</addtitle><description>Background
Metabolic acidosis in the early newborn period is associated with adverse outcomes in preterm infants. The most commonly used strategies to correct metabolic acidosis are intravascular infusion of base, for example sodium bicarbonate, and intravascular infusion of a fluid bolus, usually a crystalloid or colloid solution.
Objectives
To determine the effect of either infusion of base or of a fluid bolus on mortality and adverse neurodevelopmental outcomes in preterm infants with metabolic acidosis.
Search methods
We used the standard search strategy of the Cochrane Neonatal Review Group. This included searches of the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1, 2005), MEDLINE (1966 to January 2005), EMBASE (1980 to January 2005), CINAHL (1982 to January 2005).
The search was updated in 2010.
Selection criteria
Randomised or quasi‐randomised controlled trials that evaluated the following treatments for preterm infants with metabolic acidosis:
1. Infusion of base versus no treatment;
2. Infusion of fluid bolus versus no treatment;
3. Infusion of base versus fluid bolus.
Data collection and analysis
We extracted the data using the standard methods of the Cochrane Neonatal Review Group with separate evaluation of trial quality and data extraction by two review authors, and synthesis of data using relative risk and risk difference.
Main results
We found two small randomised controlled trails that fulfilled the eligibility criteria (Corbet 1977; Dixon 1999) and one unpublished pilot trial (Lawn 2005). Corbet 1977 compared treating infants with sodium bicarbonate infusion (N = 30) versus no treatment (N = 32) and did not find evidence of an effect on mortality [relative risk (RR) 1.39 (95% confidence interval 0.72 to 2.67)] or in the incidence of intra/periventricular haemorrhage [RR 1.24 (95% confidence interval 0.47 to 3.28)]. Addition of the unpublished data of Lawn 2005 does not change the overall estimate of effect on mortality [typical RR 1.45 (95%CI 0.82 to 2.56)]. Dixon 1999 compared treatment with sodium bicarbonate (N = 16) versus fluid bolus (N = 20). The primary outcome assessed was arterial blood pH/base excess two hours after the intervention. Other clinical outcomes were not reported. Neither trial assessed longer term neurodevelopmental outcomes.
Authors' conclusions
There is insufficient evidence from randomised controlled trials to determine whether infusion of base or fluid bolus reduces morbidity and mortality in preterm infants with metabolic acidosis. Further large randomised trials are needed.</description><subject>Acidosis</subject><subject>Acidosis - complications</subject><subject>Acidosis - drug therapy</subject><subject>Acidosis - mortality</subject><subject>Buffers</subject><subject>Child health</subject><subject>Fluid Therapy</subject><subject>Fluid Therapy - methods</subject><subject>Fluid, Electrolytes, and Acid‐Base Homeostasis</subject><subject>Humans</subject><subject>Immediate care of the newborn</subject><subject>Infant, Newborn</subject><subject>Infant, Premature</subject><subject>Infant, Premature, Diseases</subject><subject>Infant, Premature, Diseases - drug therapy</subject><subject>Infant, Premature, Diseases - mortality</subject><subject>Medicine General & Introductory Medical Sciences</subject><subject>Neonatal care</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Sodium Bicarbonate</subject><subject>Sodium Bicarbonate - administration & dosage</subject><subject>Tromethamine</subject><subject>Tromethamine - administration & dosage</subject><issn>1465-1858</issn><issn>1469-493X</issn><issn>1465-1858</issn><issn>1469-493X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>RWY</sourceid><sourceid>EIF</sourceid><recordid>eNqFUU1v3CAQRVWq5qP9CxGn3HYD2Mb4UinZ5kuK1Et7RmPAWSobNoAT7b8vaDdtkktOzOi9eW-Yh9ApJUtKCDunNW-oaMRy9YOQitFmuZl79gkdFWBRkINX9SE6jvFPJvKOtV_QIW1EzbPAEUqXEA0GPVlnYwqQrHfYBzyMs9W49-Mc8ZD7TTBPxiXrHvDkQ2-1TVsMTpcuwVg66wormTDlcgCXIn62aY0nkyALWYVBWe2jjV_R5wHGaL7t3xP0-_rq1-p2cf_z5m51cb9QleBswXVDqqFtOehedETVpIK6boRgWteiZbQlg-ho13Cq2sooZkwLHVe0F1AzU1Un6PtON99mMlrlDwQY5SbYCcJWerDyLeLsWj74JylaSpuuCJztBYJ_nE1McrJRmXEEZ_wcJc_L5TMWIt8RVfAxBjP8M6FElsDkS2DyJbBizfLg6esV_4_tE8qEyx3h2Y5mK5VX65DdP9B95_IXTO6pYQ</recordid><startdate>20050420</startdate><enddate>20050420</enddate><creator>Lawn, Cassie J</creator><creator>Weir, Fiona J</creator><creator>McGuire, William</creator><creator>Lawn, Cassie J</creator><general>John Wiley & Sons, Ltd</general><scope>7PX</scope><scope>RWY</scope><scope>ZYTZH</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><scope>5PM</scope></search><sort><creationdate>20050420</creationdate><title>Base administration or fluid bolus for preventing morbidity and mortality in preterm infants with metabolic acidosis</title><author>Lawn, Cassie J ; Weir, Fiona J ; McGuire, William ; Lawn, Cassie J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3862-6d503f776adb890c403a445882dd4872170f8919561c73ec2ee7a96c1b8a42e33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Acidosis</topic><topic>Acidosis - complications</topic><topic>Acidosis - drug therapy</topic><topic>Acidosis - mortality</topic><topic>Buffers</topic><topic>Child health</topic><topic>Fluid Therapy</topic><topic>Fluid Therapy - methods</topic><topic>Fluid, Electrolytes, and Acid‐Base Homeostasis</topic><topic>Humans</topic><topic>Immediate care of the newborn</topic><topic>Infant, Newborn</topic><topic>Infant, Premature</topic><topic>Infant, Premature, Diseases</topic><topic>Infant, Premature, Diseases - drug therapy</topic><topic>Infant, Premature, Diseases - mortality</topic><topic>Medicine General & Introductory Medical Sciences</topic><topic>Neonatal care</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Sodium Bicarbonate</topic><topic>Sodium Bicarbonate - administration & dosage</topic><topic>Tromethamine</topic><topic>Tromethamine - administration & dosage</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lawn, Cassie J</creatorcontrib><creatorcontrib>Weir, Fiona J</creatorcontrib><creatorcontrib>McGuire, William</creatorcontrib><creatorcontrib>Lawn, Cassie J</creatorcontrib><collection>Wiley-Blackwell Cochrane Library</collection><collection>Cochrane Library</collection><collection>Cochrane Library (Open Aceess)</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><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cochrane database of systematic reviews</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lawn, Cassie J</au><au>Weir, Fiona J</au><au>McGuire, William</au><au>Lawn, Cassie J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Base administration or fluid bolus for preventing morbidity and mortality in preterm infants with metabolic acidosis</atitle><jtitle>Cochrane database of systematic reviews</jtitle><addtitle>Cochrane Database Syst Rev</addtitle><date>2005-04-20</date><risdate>2005</risdate><volume>2010</volume><issue>11</issue><spage>CD003215</spage><pages>CD003215-</pages><issn>1465-1858</issn><issn>1469-493X</issn><eissn>1465-1858</eissn><eissn>1469-493X</eissn><abstract>Background
Metabolic acidosis in the early newborn period is associated with adverse outcomes in preterm infants. The most commonly used strategies to correct metabolic acidosis are intravascular infusion of base, for example sodium bicarbonate, and intravascular infusion of a fluid bolus, usually a crystalloid or colloid solution.
Objectives
To determine the effect of either infusion of base or of a fluid bolus on mortality and adverse neurodevelopmental outcomes in preterm infants with metabolic acidosis.
Search methods
We used the standard search strategy of the Cochrane Neonatal Review Group. This included searches of the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1, 2005), MEDLINE (1966 to January 2005), EMBASE (1980 to January 2005), CINAHL (1982 to January 2005).
The search was updated in 2010.
Selection criteria
Randomised or quasi‐randomised controlled trials that evaluated the following treatments for preterm infants with metabolic acidosis:
1. Infusion of base versus no treatment;
2. Infusion of fluid bolus versus no treatment;
3. Infusion of base versus fluid bolus.
Data collection and analysis
We extracted the data using the standard methods of the Cochrane Neonatal Review Group with separate evaluation of trial quality and data extraction by two review authors, and synthesis of data using relative risk and risk difference.
Main results
We found two small randomised controlled trails that fulfilled the eligibility criteria (Corbet 1977; Dixon 1999) and one unpublished pilot trial (Lawn 2005). Corbet 1977 compared treating infants with sodium bicarbonate infusion (N = 30) versus no treatment (N = 32) and did not find evidence of an effect on mortality [relative risk (RR) 1.39 (95% confidence interval 0.72 to 2.67)] or in the incidence of intra/periventricular haemorrhage [RR 1.24 (95% confidence interval 0.47 to 3.28)]. Addition of the unpublished data of Lawn 2005 does not change the overall estimate of effect on mortality [typical RR 1.45 (95%CI 0.82 to 2.56)]. Dixon 1999 compared treatment with sodium bicarbonate (N = 16) versus fluid bolus (N = 20). The primary outcome assessed was arterial blood pH/base excess two hours after the intervention. Other clinical outcomes were not reported. Neither trial assessed longer term neurodevelopmental outcomes.
Authors' conclusions
There is insufficient evidence from randomised controlled trials to determine whether infusion of base or fluid bolus reduces morbidity and mortality in preterm infants with metabolic acidosis. Further large randomised trials are needed.</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>15846651</pmid><doi>10.1002/14651858.CD003215.pub2</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1465-1858 |
| ispartof | Cochrane database of systematic reviews, 2005-04, Vol.2010 (11), p.CD003215 |
| issn | 1465-1858 1469-493X 1465-1858 1469-493X |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8711593 |
| source | MEDLINE; Alma/SFX Local Collection |
| subjects | Acidosis Acidosis - complications Acidosis - drug therapy Acidosis - mortality Buffers Child health Fluid Therapy Fluid Therapy - methods Fluid, Electrolytes, and Acid‐Base Homeostasis Humans Immediate care of the newborn Infant, Newborn Infant, Premature Infant, Premature, Diseases Infant, Premature, Diseases - drug therapy Infant, Premature, Diseases - mortality Medicine General & Introductory Medical Sciences Neonatal care Randomized Controlled Trials as Topic Sodium Bicarbonate Sodium Bicarbonate - administration & dosage Tromethamine Tromethamine - administration & dosage |
| title | Base administration or fluid bolus for preventing morbidity and mortality in preterm infants with metabolic acidosis |
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