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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

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  • 4 weeks later...
Guest sageaugie

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 by sageaugie
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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

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It's not purely metabolic acidosis here there is also respiratory acidosis . Please check for mechanical ventilator support and also correct bicarbonate deficit and maintain adequate perfusion

Dr Kamrul Hassan Shabuj

Dhaka Bangladrsh

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  • 5 weeks later...

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