Document Detail

Sodium bicarbonate in cardiac arrest: a reappraisal.
MedLine Citation:
PMID:  8924147     Owner:  NLM     Status:  MEDLINE    
The routine use of sodium bicarbonate in patients with cardiac arrest has been discouraged, with the benefit of outcome evaluation. Current recommendations include an elaborate stratification of circumstances in which bicarbonate is to be used. The physiological and clinical aspects of bicarbonate administration during cardiopulmonary resuscitation in animal and human studies were reviewed. The onset of significant acidemia or alkalemia is associated with adverse system specific effects. The administration of bicarbonate may mitigate the adverse physiological effects of acidemia, improve response to exogenously administered vasopressor agents, or simply increase venous return due to an osmolar effect, resulting in increased coronary perfusion pressure. Likewise, bicarbonate may have adverse effects in each of these areas. The preponderance of evidence suggests that bicarbonate is not detrimental and may be helpful to outcome from cardiac arrest. An objective reappraisal of the empirical use of bicarbonate or other buffer agents in the appropriate "therapeutic window" for cardiac patients may be warranted.
R B Vukmir; N Bircher; P Safar
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The American journal of emergency medicine     Volume:  14     ISSN:  0735-6757     ISO Abbreviation:  Am J Emerg Med     Publication Date:  1996 Mar 
Date Detail:
Created Date:  1996-11-13     Completed Date:  1996-11-13     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8309942     Medline TA:  Am J Emerg Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  192-206     Citation Subset:  IM    
Department of Anesthesiology/Critical Care Medicine, University of Pittsburgh Medical Center, PA 15213-2582, USA.
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MeSH Terms
Acid-Base Equilibrium
Acidosis / drug therapy
Central Nervous System / drug effects
Disease Models, Animal
Heart / drug effects
Heart Arrest / drug therapy*,  metabolism,  physiopathology*
Hemodynamics / drug effects
Lung / drug effects
Myocardium / metabolism
Sodium Bicarbonate / pharmacology,  therapeutic use*
Reg. No./Substance:
144-55-8/Sodium Bicarbonate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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