Posted October 23, 201212 yr Hello, what is the general consensus of the use of bicarbonate in your NICU's. Do you use it often? Continuos infusion? Bolus? Thank you! Greetings from Mexico City Sion. Sent from my iPhone using Tapatalk
October 23, 201212 yr We hardly use it anymore. There seems to be no evidence that administration of bicarbonate improves outcome. In fact, it can be detrimental. Wat does improve outcome is adequate treatment of the underlying cause of acidemia. http://pediatrics.aappublications.org/content/122/4/831.long Best regards Christ-jan van Ganzewinkel Neonatal Nurse Practitioner NICU Máxima Medical Centre, Veldhoven The Netherlands
November 17, 201212 yr comment_6454 A Term baby, out-born with perinatal asphyxia was referred to our unit at 2hrs of life. Initial examination findings HR 136/min; RR: 88/min; NIBPmean: 36mmHg; SPo2:94% with 2L/min O2 through head box, CFT=2sec, warm Initial blood gases revealed metabolic acidosis with pH of 7.167, PCO2-34.9;HCO3-13.6 and BE of -16. Should i correct the metabolic acidosis with sodium bicarbonate? Edited November 17, 201212 yr by sageaugie
November 17, 201212 yr Initial blood gases revealed metabolic acidosis with pH of 7.167, PCO2-34.9;HCO3-13.6 and BE of -16. Should i correct the metabolic acidosis with sodium bicarbonate? I'd would say, wait and see/re-check the blood gas.
November 17, 201212 yr No, your bloodgas will Look better, but no effect on outcome, in fact Babys cardiac function might be impaired.
November 18, 201212 yr I am in favour of giving NS bolus 10ml/kg over 30 minute ,ask for functional echocardiography and cardiac support if required .Repeat ABG after a hour or two.W/F cardic function and renal function if normal.this might help to correct metabolic acidosis.rRespiratory function looks to be good. Dinesh
November 23, 201212 yr we use boluses, very few pts once recieving bicarb ever have a chance ,most dont improve esp critical patients, though we had to use it in a few with renal failure when the results were bettter clinically,
November 23, 201212 yr Earlier, we often used bicarbonate infusion for correction of metabolic acidosis. Sometimes we use prolonged infusion with low speed of infusion.
November 23, 201212 yr The effect of iv bicarbonate is very doubtful. You may see improvements in your analysis but as often without any improvements in clinic
December 6, 201212 yr You can wait or you can gine one bolus dodse normal saline 10 ml/kg & then rpt gases after one hour
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