Zilleruelo G, Sultan S, Bancalari E, Steele B, Strauss J
Biol Neonate. 1986;49(3):132-9. doi: 10.1159/000242523.
We studied the fractional excretion of bicarbonate (FE HCO-3) in 10 low birth weight infants aged 1-6 days during metabolic acidosis (base excess greater than or equal to -5 mEq/l) and during subsequent sodium HCO-3 infusion. The mean birth weight was 1,095 g; the mean gestational age was 29 weeks. The ability to decrease urine pH to less than 5.5 and FE HCO-3 to less than 1% during metabolic acidosis was not limited by low gestational age or birth weight. After HCO-3 therapy, all infants corrected their negative base excess, and plasma HCO-3 increased significantly. All infants with blood pH less than or equal to 7.22 or PaCO2 greater than or equal to 50 mm Hg had minimal or absent FE HCO-3. Infants with elevated PaCO2 and mild or absent acidosis also had complete HCO-3 tubular reabsorption. These results suggest that the HCO-3 tubular reabsorption is adequate during metabolic and/or respiratory acidosis in low birth weight infants.
我们研究了10名出生体重低的婴儿（年龄为1 - 6天）在代谢性酸中毒（碱剩余大于或等于 -5 mEq/l）期间以及随后输注碳酸氢钠期间的碳酸氢盐排泄分数（FE HCO-3）。平均出生体重为1095克；平均胎龄为29周。在代谢性酸中毒期间，将尿液pH值降至低于5.5且FE HCO-3降至低于1%的能力不受低胎龄或出生体重的限制。碳酸氢盐治疗后，所有婴儿均纠正了负碱剩余，血浆碳酸氢盐显著升高。所有血pH值小于或等于7.22或动脉血二氧化碳分压（PaCO2）大于或等于50 mmHg的婴儿FE HCO-3极少或不存在。PaCO2升高且酸中毒轻微或不存在的婴儿也有完全的碳酸氢盐肾小管重吸收。这些结果表明，低出生体重婴儿在代谢性和/或呼吸性酸中毒期间肾小管对碳酸氢盐的重吸收是充足的。
