Sodium bicarbonate boluses increased blood pressure and heart rate, and improved arterial oxygen saturation especially in children with pH < 7.20 or bicarbonate < 18 mEq/L.
Does sodium bicarbonate bolus administration improve hemodynamic and oximetric parameters in children with single ventricle parallel circulation?
Sodium bicarbonate boluses improve hemodynamic and oximetric parameters in children with single ventricle parallel circulation, particularly in those with pre-existing acidosis (pH < 7.20 or bicarbonate < 18 mEq/L).
Absolute Event Rate: 0% vs 0%
Introduction: To evaluate the hemodynamic and oximetric changes in patients with parallel circulation (Norwood, hybrid, and BT-shunted) after sodium bicarbonate bolus administration. Methods: Retrospective analysis of physiologic data. To eliminate confounders, sodium bicarbonate boluses concurrently administered with normal saline, 5% albumin, epinephrine boluses, blood transfusions, change in VIS or mechanical circulatory support were excluded. Blood pressure, arterial oxygen saturation, heart rate, cerebral and renal NIRS were continuously recorded from one-hour pre to one-hour post each intervention. Results: Out of 429 boluses, 293 boluses met the inclusion criteria. Measurements show an increase in blood pressure (p = 0.01) and heart rate (p < 0.01), and a decrease in pulmonary-to-systemic flow ratio (p = 0.02) and renal oxygen extraction ratio (p = 0.04) at some point during the first hour post bolus. The arterial oxygen saturation increased, and the renal oxygen extraction ratio decreased for those patients with pre-bolus pH < 7.20 and/or pre-bolus serum bicarbonate level < 18 mEq/L, according to linear regression models (p < 0.05). Conclusions: Sodium bicarbonate was associated with improvement of hemodynamic and oximetric parameters in this cohort, particularly for those patients with pH < 7.20 and/or serum bicarbonate level < 18 mEq/L. This finding is consistent with an increase in cardiac output due to the removal of the acidotic negative inotropic effect by the sodium bicarbonate.
Savorgnan et al. (Thu,) reported a other. Sodium bicarbonate boluses increased blood pressure and heart rate, and improved arterial oxygen saturation especially in children with pH < 7.20 or bicarbonate < 18 mEq/L.