Uses and abuses of sodium bicarbonate in the neonatal intensive care unit.
Despite the lack of evidence for its effectiveness in the treatment of acid-base disturbances in critically ill patients of all ages, and despite several lines of evidence that indicate it might be dangerous, bicarbonate therapy is used routinely in many neonatal intensive care units. The justification for the persistent use of this controversial therapy comes from a variety of sources, many based more in philosophy than in science. Clinicians contemplating the use of bicarbonate therapy should consider what they expect the intervention to accomplish and what evidence exists that their therapeutic objective will be met. Without rigorous scientific support for this therapy, it should be considered of unproven value and, therefore, experimental.
Ammari
Amer N
AN
Division of Neonatal-Perinatal Medicine, Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, New York 10032, USA. ana2003@columbia.edu
Schulze
Karl F
KF
D000140:Acidosis, Lactic / Q000188:drug therapy*; D000142:Acidosis, Respiratory / Q000188:drug therapy*; D000208:Acute Disease; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D002983:Clinical Competence; D019317:Evidence-Based Medicine; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D012127:Respiratory Distress Syndrome, Newborn / Q000188:drug therapy*; D017693:Sodium Bicarbonate / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
D017693:Sodium Bicarbonate