Nagasaka S
Department of Anesthesiology, Nihon University School of Medicine, Tokyo.
Masui. 1991 Dec;40(12):1810-8.
Sodium bicarbonate has been thought to be effective for hypoxic lactic acidosis, but recently its adverse reactions have been pointed out. Therefore, the effects of NaHCO3 therapy in hypoxic lactic acidosis were evaluated in the anesthetized dog. Studies were carried out in four groups of adult mongrel dogs. The first group received control ventilation with hypoxic gas (5%O2 + 95%N2) and NaHCO3 therapy to adjust blood base excess. The second group did not receive NaHCO3 therapy after control ventilation with hypoxic gas. The third group breathed hypoxic gas spontaneously and received NaHCO3 therapy. The fourth group did not receive NaHCO3 therapy during spontaneous breathing of hypoxic gas. The changes of acid-base balance, CO2 and lactate of arterial blood and cerebrospinal fluid (CSF) were analysed in each dog. The conclusions were as follows; 1. The NaHCO3 therapy is not necessary for hypoxic lactic acidosis under proper ventilation, if arterial blood pH does not fall extremely. 2. The CSF acid-base balance is kept within normal ranges, so that the NaHCO3 therapy is not necessary from this point of view.
碳酸氢钠曾被认为对低氧性乳酸性酸中毒有效，但最近其不良反应已被指出。因此，在麻醉犬身上评估了碳酸氢钠治疗低氧性乳酸性酸中毒的效果。对四组成年杂种犬进行了研究。第一组接受低氧气体（5%氧气+95%氮气）控制通气并进行碳酸氢钠治疗以调整血液碱剩余。第二组在低氧气体控制通气后未接受碳酸氢钠治疗。第三组自主呼吸低氧气体并接受碳酸氢钠治疗。第四组在自主呼吸低氧气体期间未接受碳酸氢钠治疗。分析了每只犬动脉血和脑脊液（CSF）的酸碱平衡、二氧化碳和乳酸的变化。结论如下：1. 在适当通气且动脉血pH未极度下降的情况下，低氧性乳酸性酸中毒无需碳酸氢钠治疗。2. 脑脊液酸碱平衡保持在正常范围内，因此从这一角度来看无需碳酸氢钠治疗。
