Carroll G C
Department of Anesthesiology, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612.
Resuscitation. 1990 Jun;19(3):253-70. doi: 10.1016/0300-9572(90)90106-o.
Effects of intravenous normal saline, sodium bicarbonate, hypertonic saline, and Tromethamine were studied in 21 pigs and 60 rats subjected to acute, severe respiratory acidosis. Transient multiphasic alterations of systemic arterial pressures were seen with boluses of each agent-especially sodium bicarbonate and hypertonic saline-but any improvements in hemodynamic variables were transient. At the dose given, sodium bicarbonate significantly increased PaCO2 while decreasing hydrogen ion (H+) accumulation, whereas tromethamine buffered pH without significantly increasing PaCO2. However, no change of either arterial or venous H+ or PCO2 could be identified which rapidly produced death. Survival times were statistically equivalent among all groups. Therefore, intravenous treatment of respiratory acidosis with fluids or alkalinizing agents appears neither helpful nor harmful.
在21只猪和60只大鼠身上研究了静脉注射生理盐水、碳酸氢钠、高渗盐水和氨丁三醇对急性重度呼吸性酸中毒的影响。给予每种药物推注后均可见全身动脉压的短暂多相改变，尤其是碳酸氢钠和高渗盐水，但血流动力学变量的任何改善都是短暂的。在给予的剂量下，碳酸氢钠显著增加了动脉血二氧化碳分压（PaCO2），同时减少了氢离子（H+）的蓄积，而氨丁三醇缓冲了pH值，且未显著增加PaCO2。然而，未发现能迅速导致死亡的动脉或静脉H+或PCO2的变化。所有组的生存时间在统计学上相当。因此，用液体或碱化剂静脉治疗呼吸性酸中毒似乎既无帮助也无害。
