Sodium Bicarbonate Administration During Cardiac Arrest: Title and subTitle BreakEffect on Arterial pH, Pco2, and Osmolality FREE

Richard L. Bishop, MD; Myron L. Weisfeldt, MD

[+] Author Affiliations

Reprint requests to the Cardiovascular Division, Johns Hopkins Hospital, 601 N Broadway, Baltimore, MD 21205 (Dr Weisfeldt).

JAMA. 1976;235(5):506-509. doi:10.1001/jama.1976.03260310020014

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ABSTRACT

ABSTRACT | REFERENCES

Arterial pH, Pco₂, and osmolality were determined serially during cardiac resuscitation in patients and in dogs, with and without administration of sodium bicarbonate. These studies demonstrate that (1) in the absence of preexisting acidosis, severe acidosis can be prevented by adequate ventilation alone; (2) sodium bicarbonate administration results in a significant rise in arterial Pco₂, which parallels the rise in pH despite adequate ventilation; (3) during prolonged cardiac arrest and resuscitation, there is a rise in arterial osmolality that is accentuated by sodium bicarbonate. These studies suggest that sodium bicarbonate should not be used during resuscitation (1) in the absence of effective hyperventilation or where carbon dioxide removal is inadequate despite adequate ventilation, (2) in repeated doses, without confirmation of substantial acidosis, or (3) when cardiac arrest has been of brief duration and preexisting acidosis is unlikely. These studies also point to the need for a reappraisal of other buffers that do not elevate the arterial Pco₂.

(JAMA 235:506-509, 1976)

REFERENCES

ABSTRACT | REFERENCES

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Weisfeldt ML, Scully HE, Selden R, et al: Effect of mannitol on the performance of the isolated canine heart after fibrillatory arrest . J Thorac Cardiovasc Surg 66:290-299, 1973;.

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