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Na Bicarbonate for neonates


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the use of na bicarbnate is very precise, and i think this papers are usefull to find the correct answer:

1) Effects of Rapid versus Slow Infusion of Sodium

Bicarbonate on Cerebral Hemodynamics and

Oxygenation in Preterm Infants

Biol Neonate 2006;90:122–127.

2) Severe Umbilical Cord Acidemia and

Neurological Outcome in

Preterm and Full-Term Neonates

Biol Neonate 2005;88:27–34.

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  • 2 weeks later...

Dear hehady

Addressing Bicarbonate therapy:

- During resuscitation, I suggest to follow the NRP guidelines ie. 4 cc/kd of BiC 4.2% during 10-15 mn.

- The treatment of prolonged mild acidosis is more controversial. Sometimes is may due to dehydration and the treatment must be correction of dehydration instead of giving BiC with all its side effects. When the acidosis is pure metabolic and not in emergency I found that there are controversies and no concensus about the right way to treat it.

I hope that I helped a little in solving part of the dilemma.

Moti Ben Elisha


Nahariya hospital for Western Galilee


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  • 1 month later...

Dear collegue,

just my vision to your question:

1.During resuscitation in delivery room bicarb allows to save the live but not the brain, unfortunately.

2.In NICU first step would be most appropriate to try to find main cause of acidosis, after to try solve it and after - bicarb ... maybe.

3.In our practise we have very few indications for use bicarb - late shock with no responce to fluids and inotropes and some cong metabolic diseases(rare).

Re AAP recomendations: if you follow them, they are in permanent process of changes( ventilation/chest compressions ratio, oxygen, prevention of MAS, etc.). I believe that bicarb will be removed from the list of delivery room drugs in the future.


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  • 2 years later...

dear colleagues..

best wishes.. as for the use of Bicarbonate.. we try to limit it to minumum especially in delivery room for neonatal resuscitation almost nill...in nicu we try to correct the acidosis by improving oxygenation , perfusion , cardiac actions..


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