Department of Intensive Care Medicine, Austin Hospital, Melbourne,Vic, Australia.
Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic, Australia.
Crit Care Resusc. 2020 Mar;22(1):83-85. doi: 10.51893/2020.1.tn2.
The benefit of intravenous sodium bicarbonate administration in patients with severe metabolic acidosis remains controversial, partly due to lack of double-blind trials. From a practical viewpoint, such blinding requires testing of the stability of sodium bicarbonate in polyolefin bags.
We examined seven samples of 100 mL 8.4% sodium bicarbonate diluted in 150 mL normal saline within a 250 mL polyolefin bag at time 0, 24 and 48 hours after preparation. We measured pH, Pco, and bicarbonate concentration.
Over a period of 48 hours, both pH and Pco decreased significantly (hourly rate of change, -0.001 [ = 0.043) and -0.098 [ < 0.001] respectively). However, the concentration of bicarbonate did not decrease, with an hourly rate of change of only -0.009 ( = 0.42).
When 100 mL of 8.4% sodium bicarbonate are diluted in 150 mL of normal saline within a 250 mL polyolefin bag, changes in pH and Pco over a 48-hour period are small and bicarbonate concentration remains stable.
静脉注射碳酸氢钠治疗严重代谢性酸中毒的益处仍存在争议，部分原因是缺乏双盲试验。从实际角度来看，这种盲法需要测试碳酸氢钠在聚烯烃袋中的稳定性。
我们在制备后 0、24 和 48 小时时检查了在 250 毫升聚烯烃袋中稀释在 150 毫升生理盐水内的 7 份 100 毫升 8.4%碳酸氢钠样本。我们测量了 pH 值、Pco 和碳酸氢盐浓度。
在 48 小时内，pH 值和 Pco 均显著下降（每小时变化率分别为-0.001[=0.043]和-0.098[<0.001]）。然而，碳酸氢盐浓度没有下降，每小时变化率仅为-0.009（=0.42）。
当 100 毫升 8.4%碳酸氢钠在 250 毫升聚烯烃袋中稀释在 150 毫升生理盐水中时，48 小时内 pH 值和 Pco 的变化很小，碳酸氢盐浓度保持稳定。
