Inadequate bicarbonate resuscitation in trauma patients requiring crossclamping of the aorta.
The use of bicarbonate in the management of metabolic acidosis is controversial. We present three patients who required crossclamping of the aorta for control of shock and whose metabolic acidosis was inadequately treated with bicarbonate. Within minutes of aortic declamping, all became hypotensive and two went into refractory ventricular fibrillation and died. Arguments supporting the role of adequate bicarbonate resuscitation in this setting are discussed.
Baumgartner
F J
FJ
Harbor-UCLA Medical Center, Department of Surgery, Torrance, 90509.
Bongard
F S
FS
Klein
S R
SR
D000138:Acidosis / Q000628:therapy*; D000328:Adult; D001011:Aorta; D001639:Bicarbonates / Q000627:therapeutic use*; D003250:Constriction; D005440:Fluid Therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012151:Resuscitation; D012774:Shock, Traumatic / Q000628:therapy*
D001639:Bicarbonates