Correction of metabolic acidosis in experimental CPR: a comparative study of sodium bicarbonate, carbicarb, and dextrose.
OBJECTIVE
Carbicarb, sodium bicarbonate, and 5% dextrose were compared for effects on resuscitability in a canine model of electromechanical dissociation after ventricular fibrillation.


METHODS
21 healthy mongrel dogs were anesthetized with pentobarbital, intubated, and mechanically supported. They were instrumented to measure heart rate, arterial pressure, pulmonary artery pressure, right atrial pressure, cardiac output, and arterial and mixed venous blood gases. The dogs were then subjected to a protocol that consisted of three successive CPR episodes. During each episode they were treated with repeated injections of one of the three substances, randomly chosen. After two minutes of ventricular fibrillation and four minutes of electromechanical dissociation, CPR was started with a thumper (rate, 60; duty cycle, 50%). If recovery was not obtained after five minutes of CPR, 1 mEq/kg carbicarb or sodium bicarbonate or 5 mL D5W was injected in the right atrium. Half the dose of the same substance was injected every five minutes thereafter; 1 mg epinephrine was also injected every five minutes until recovery. Hemodynamic and gasometric evaluations were performed five and 20 minutes after recovery. This later evaluation served as baseline for the next CPR episode.


RESULTS
The duration and success rates of CPR are similar in the three CPR groups. Hemodynamic parameters were also similar during recovery. Bicarbicarb and sodium bicarbonate increased bicarbonate levels and corrected pH in the arterial and mixed venous blood. There was no difference in the blood gas values after carbicarb and sodium bicarbonate.


CONCLUSIONS
In this model of cardiac arrest, carbicarb was not superior to sodium bicarbonate in the correction of metabolic acidosis during CPR.
Blecic
S
S
Department of Intensive Care, Erasme University Hospital, Free University of Brussels, Belgium.
De Backer
D
D
Deleuze
M
M
Vachiery
J L
JL
Vincent
J L
JL
D000140:Acidosis, Lactic / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D000818:Animals; D001639:Bicarbonates / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D001784:Blood Gas Analysis; D002254:Carbonates / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D002985:Clinical Protocols / Q000592:standards*; D004195:Disease Models, Animal; D004285:Dogs; D004338:Drug Combinations; D005947:Glucose / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D006323:Heart Arrest / Q000150:complications* / Q000503:physiopathology; D006439:Hemodynamics / Q000187:drug effects; D012151:Resuscitation / Q000592:standards*; D012964:Sodium / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D017693:Sodium Bicarbonate
D001639:Bicarbonates; D002254:Carbonates; D004338:Drug Combinations; C046283:sodium bicarbonate, sodium carbonate drug combination; D017693:Sodium Bicarbonate; D012964:Sodium; D005947:Glucose