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Titolo:
Sodium bicarbonate for the treatment of lactic acidosis
Autore:
Forsythe, SM; Schmidt, GA;
Indirizzi:
Univ Chicago, Sch Med, Sect Pulm & Crit Care, Chicago, IL 60637 USA Univ Chicago Chicago IL USA 60637 Pulm & Crit Care, Chicago, IL 60637 USA Univ Chicago, Sch Med, Dept Med, Chicago, IL 60637 USA Univ Chicago Chicago IL USA 60637 ch Med, Dept Med, Chicago, IL 60637 USA
Titolo Testata:
CHEST
fascicolo: 1, volume: 117, anno: 2000,
pagine: 260 - 267
SICI:
0012-3692(200001)117:1<260:SBFTTO>2.0.ZU;2-J
Fonte:
ISI
Lingua:
ENG
Soggetto:
RESPIRATORY-DISTRESS-SYNDROME; LEFT-VENTRICULAR CONTRACTILITY; SEVERE DIABETIC-KETOACIDOSIS; METABOLIC-ACIDOSIS; INTRACELLULAR PH; PERMISSIVE HYPERCAPNIA; CARDIAC-ARREST; MECHANICAL VENTILATION; SYSTEMIC ACIDOSIS; CYTOPLASMIC PH;
Keywords:
acid-base; acidosis; alkalinizing therapy; bicarbonate; lactic acidosis; sodium bicarbonate;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
91
Recensione:
Indirizzi per estratti:
Indirizzo: Schmidt, GA Univ Chicago, Sch Med, Sect Pulm & Crit Care, MC6026,5841 S Maryland Ave, Chicago, IL 60637 USA Univ Chicago MC6026,5841 S Maryland Ave Chicago IL USA 60637 A
Citazione:
S.M. Forsythe e G.A. Schmidt, "Sodium bicarbonate for the treatment of lactic acidosis", CHEST, 117(1), 2000, pp. 260-267

Abstract

Lactic acidosis often challenges the intensivist and is associated with a strikingly high mortality. Treatment involves discerning and correcting itsunderlying cause, ensuring adequate oxygen delivery to tissues, reducing oxygen demand through sedation and mechanical ventilation, and (most controversially) attempting to alkalinize the blood with IV sodium bicarbonate. Here we review the literature to answer the following questions: Is a low pH had? Can sodium bicarbonate raise the pH in vivo? Does increasing the bloodpH with sodium bicarbonate have any salutary effects? Does sodium bicarbonate have negative side effects? We find that the oft-cited rationale for bicarbonate use, that it might ameliorate the hemodynamic expression of metabolic acidemia, has been disproved convincingly. Further, given the lack of evidence supporting its use, we cannot condone bicarbonate administration for patients with lactic acidosis, regardless of the degree of acidemia.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 02/04/20 alle ore 02:46:45