[Should bicarbonates still be administered in lactic acidosis?].
Bicarbonate administration during lactic acidosis seems logical in view of the myocardial depression associated with the decrease in intracellular pH. This treatment has been recently challenged on the basis of observations showing an increase in the veno-arterial gradient for CO2 during acute circulatory failure. The partial transformation of bicarbonate in CO2 carries the risk of aggravating the phenomenon and thereby decreasing intracellular pH. Alternatives to sodium bicarbonate--carbicarb, THAM and dichloroacetate--are discussed.
Vincent
J L
JL
Service des Soins Intensifs, Hôpital Erasme, Bruxelles.
Blecic
S
S
Preiser
J C
JC
Zhang
H
H
D000140:Acidosis, Lactic / Q000188:drug therapy*; D001639:Bicarbonates / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000627:therapeutic use; D002245:Carbon Dioxide / Q000378:metabolism; D002254:Carbonates / Q000627:therapeutic use; D003999:Dichloroacetic Acid / Q000627:therapeutic use; D004338:Drug Combinations; D006801:Humans; D006863:Hydrogen-Ion Concentration; D017693:Sodium Bicarbonate; D014325:Tromethamine / Q000627:therapeutic use
D001639:Bicarbonates; D002254:Carbonates; D004338:Drug Combinations; C046283:sodium bicarbonate, sodium carbonate drug combination; D014325:Tromethamine; D002245:Carbon Dioxide; D017693:Sodium Bicarbonate; D003999:Dichloroacetic Acid
Faut-il encore administrer du bicarbonate dans l'acidose lactique?