Omar Ibrahim Ifrah, Perrot Chloé, Roumes Hélène, Beauvieux Marie-Christine, Brissaud Olivier, Cramaregeas Sophie, Dumas-de-la-Roque Eric, Pellerin Luc, Chateil Jean-François, Tandonnet Olivier, Bouzier-Sore Anne-Karine
Univ. Bordeaux, CNRS, CRMSB, UMR 5536, F-33000 Bordeaux, France.
Neonatal Intensive Care Unit, Maternity, Bordeaux University Hospital, Bordeaux, France.
Pediatr Res. 2025 Mar 6. doi: 10.1038/s41390-025-03963-9.
Preclinical studies indicate that lactate is a crucial cerebral energy substrate, with Na-L-lactate administration significantly reducing brain lesion volumes and improving motor and cognitive functions following neonatal hypoxia-ischemia in rat pups. Its neuroprotective effects are linked to neuronal metabolic utilization, making it a promising candidate for treating newborns with hypoxia-ischemia encephalopathy, a condition where hypothermia remains the only established therapy. However, before initiating a clinical trial, it is necessary to assess the effects of Na-L-lactate infusion on blood parameters.
We retrospectively analyzed blood parameters in 60 premature neonates during their first days of life. Among them, 30 received Na-L-lactate instead of Na-Cl to prevent hyperchloremic acidosis. Blood pH, lactatemia, bicarbonates, glycemia, natremia, chloremia, base excess, and hemoglobin were monitored before, during, and after Na-L-lactate infusion.
Our findings showed that Na-L-lactate infusion lowered blood lactate levels while increasing pH from 7.25 to 7.31. After stopping the infusion, lactatemia was 1.9 mM, and pH reached 7.32. Na-L-lactate supplementation effectively restored normal blood pH, maintained natremia, and prevented hyperchloremia. Notably, even in cases of high initial lactatemia, lactate levels decreased during the infusion.
Our data are promising and emphasize the need for further research to explore its potential applications in neonatal clinical care.
Sodium L-lactate infusion does not increase blood lactate levels and restores normal pH in premature neonates. The study demonstrates that sodium L-lactate infusion avoids hyperchloremia while maintaining sodium levels, offering a potential alternative to sodium chloride. These findings highlight the need for additional research studies to further evaluate the safety, efficacy, and potential applications of sodium L-lactate infusion in neonatal care.
临床前研究表明，乳酸是一种关键的脑能量底物，给予新生大鼠幼崽L-乳酸钠可显著减少脑损伤体积，并改善新生儿缺氧缺血后的运动和认知功能。其神经保护作用与神经元代谢利用有关，这使其成为治疗缺氧缺血性脑病新生儿的有前景的候选药物，而低温仍是该病症唯一已确立的治疗方法。然而，在开展临床试验之前，有必要评估输注L-乳酸钠对血液参数的影响。
我们回顾性分析了60例早产儿出生后最初几天的血液参数。其中，30例接受L-乳酸钠而非氯化钠以预防高氯性酸中毒。在输注L-乳酸钠之前、期间和之后监测血液pH值、血乳酸水平、碳酸氢盐、血糖、血钠、血氯、碱剩余和血红蛋白。
我们的研究结果表明，输注L-乳酸钠可降低血乳酸水平，同时使pH值从7.25升至7.31。停止输注后，血乳酸水平为1.9 mM，pH值达到7.32。补充L-乳酸钠有效恢复了正常血液pH值，维持了血钠水平，并预防了高氯血症。值得注意的是，即使在初始血乳酸水平较高的情况下，输注期间乳酸水平也会下降。
我们的数据很有前景，并强调需要进一步研究以探索其在新生儿临床护理中的潜在应用。
输注L-乳酸钠不会增加早产儿的血乳酸水平，并可恢复正常pH值。该研究表明，输注L-乳酸钠可避免高氯血症，同时维持钠水平，为氯化钠提供了一种潜在的替代方案。这些发现凸显了需要开展更多研究，以进一步评估输注L-乳酸钠在新生儿护理中的安全性、有效性和潜在应用。
