The effects of sodium bicarbonate on brain blood flow, brain water content, and blood-brain barrier in the neonatal dog.

To explore the relationship between cerebral hemorrhage in the newborn and administration of sodium bicarbonate, we gave a standard dose of sodium bicarbonate (5 mEq/kg) to neonatal dogs and then assessed changes in cerebral blood flow, brain water content, and the blood-brain barrier. This dose of sodium bicarbonate produced no increase in blood pressure or cerebral blood flow and no alteration in blood-brain barrier. However, infusion of sodium bicarbonate did cause hyperosmolality and hypernatremia and a significant decrease in brain water content. Cerebral hemorrhage in the neonate associated with infusions of sodium bicarbonate may be related to shifts in brain water rather than to changes in blood pressure or cerebral blood flow.