Buysse Corinne M P, de Jongste Johan C, de Hoog Matthijs
Division of Pediatric Intensive Care, Erasmus MC-Sophia Children's Hospital, Dr. Molewaterplein 60, 3015 GJ Rotterdam, the Netherlands.
Chest. 2005 Mar;127(3):866-70. doi: 10.1378/chest.127.3.866.
To assess the effect of administration of sodium bicarbonate on carbon dioxide levels in children with life-threatening asthma (LTA) and to evaluate the clinical effect of this treatment.
Retrospective study.
A pediatric ICU (PICU) of a tertiary care university hospital.
Seventeen children with LTA who received sodium bicarbonate.
In January 1999, a new protocol for the treatment of LTA was initiated in our institution, incorporating the use of IV sodium bicarbonate in acidotic patients (pH < 7.15) with refractory status asthmaticus. Since January 1999, sodium bicarbonate was administered to 17 patients; 5 patients received two or three doses of sodium bicarbonate. In three patients, sodium bicarbonate was administered after intubation. Intubation and mechanical ventilation were performed in five patients before admission to the PICU, and in one patient during admission. There was a significant decrease of Pco(2) after sodium bicarbonate infusion (p = 0.007). An improvement of respiratory distress in all but one patient was seen as well.
Administration of sodium bicarbonate in 17 children with LTA was associated with a significant decrease in Pco(2) and an improvement of respiratory distress. The possible benefits of sodium bicarbonate in LTA deserve further study in a controlled, prospective design.
评估给予碳酸氢钠对危及生命哮喘（LTA）患儿二氧化碳水平的影响，并评估该治疗的临床效果。
回顾性研究。
一所三级医疗大学医院的儿科重症监护病房（PICU）。
17名接受碳酸氢钠治疗的LTA患儿。
1999年1月，我们机构启动了一项新的LTA治疗方案，在患有难治性哮喘持续状态的酸中毒患者（pH < 7.15）中使用静脉注射碳酸氢钠。自1999年1月以来，17名患者接受了碳酸氢钠治疗；5名患者接受了两剂或三剂碳酸氢钠。3名患者在插管后给予碳酸氢钠。5名患者在入住PICU前进行了插管和机械通气，1名患者在住院期间进行了插管和机械通气。输注碳酸氢钠后Pco(2)显著降低（p = 0.007）。除1名患者外，其他所有患者的呼吸窘迫均有改善。
17名LTA患儿给予碳酸氢钠治疗后，Pco(2)显著降低，呼吸窘迫得到改善。碳酸氢钠在LTA中的潜在益处值得在对照的前瞻性研究中进一步探讨。
