Document Detail


Rapid infusion of sodium bicarbonate and albumin into high-risk premature infants soon after birth: a controlled, prospective trial.
MedLine Citation:
PMID:  2013     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We conducted a controlled, prospective trial to evaluate the effectiveness of rapidly infusing sodium bicarbonate (NaHCO3) and salt-poor albumin into high-risk, premature infants in the first 2 hours of life. Fifty-three infants, randomized into one of four treatment groups, received 8 ml. per kilogram of a solution containing either (A) glucose in water, (B) salt-poor albumin, (C) NaHCO3, or (D) a combination of albumin and NaHCO3. After the initial infusion, the babies received no colloid or alkali solutions until 4 hours of age. We managed them supportively with warmth, appropriate oxygen administration, isotonic fluid infusion, and close monitoring. Among the infants who received alkali, 14 of 26 acquired the respiratory distress syndrome (RDS), 11 died, and four had intracranial hemorrhage. Among babies who received no alkali, RDS occurred in 11 of 27, 5 died, and none had intracranial hemorrhage. These results do not support the common practice of rapidly infusing NaHCO3 into high-risk, premature infants, and they suggest that the early management of such infants needs renewed critical evaluation.
Authors:
R D Bland; T L Clarke; L B Harden
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  124     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  1976 Feb 
Date Detail:
Created Date:  1976-03-30     Completed Date:  1976-03-30     Revised Date:  2014-06-17    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  263-7     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Acidosis / drug therapy*
Albumins / administration & dosage,  therapeutic use*
Bicarbonates / administration & dosage,  therapeutic use*
Carbon Dioxide / blood
Cerebral Hemorrhage / mortality
Female
Hawaii
Humans
Hydrogen-Ion Concentration
Infant, Newborn
Infant, Premature, Diseases / blood,  drug therapy*,  mortality
Infusions, Parenteral
Male
Prospective Studies
Respiratory Distress Syndrome, Newborn / mortality
Sodium / administration & dosage,  therapeutic use*
Time Factors
Grant Support
ID/Acronym/Agency:
089752//Wellcome Trust; 095121//Wellcome Trust; 095938//Wellcome Trust; 097170//Wellcome Trust; 098497//Wellcome Trust; PG/11/44/28972//British Heart Foundation
Chemical
Reg. No./Substance:
0/Albumins; 0/Bicarbonates; 142M471B3J/Carbon Dioxide; 9NEZ333N27/Sodium
Comments/Corrections
Comment In:
J Gastrointest Surg. 2014 Apr;18(4):884   [PMID:  24557488 ]

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