Relationship of sodium bicarbonate to intraventricular hemorrhage in premature infants with respiratory distress syndrome.

It has been suggested that hypertonic loads of saline built up in the administration of sodium bicarbonate to correct acidosis in infants with respiratory distress syndrome (IRDS) can precipitate intraventricular hemorrhage (IVH). Therefore, from medical records we noted the daily intake of sodium of 36 babies with IRDS who were on mechanical respirators. Eighteen of the infants developed IVH, and for these infants total sodium intake 24 hours prior to IVH was also recorded. The mean was 5.83 +/- 4.22 mEq/kg per day, a dose substantially less than the recommended limit of 8 mEq/kg per day. The difference between means was not significant (p = .071), but the variance was significant (p = .016). The results indicated that the total sodium dose, particularly that taken in during the sodium bicarbonate administration, did not regularly contribute to the development of IVH, when given under controlled conditions, that is, conservative doses, dilution, and slow injection to minimize the hypertonic load.