Suzuki T
Department of Anesthesiology, Fukushima Medical College.
Masui. 1994 May;43(5):702-9.
Several recent studies evaluated alkali therapy for lactic acidosis (LA). We studied the effects of sodium bicarbonate (NaHCO3) on LA due to hemorrhagic shock in dogs. After inducing hemorrhagic shock in twelve mongrel dogs, we divided them into two groups: the first group was treated with 7% NaHCO3 and the second with 4.9% sodium chloride (NaCl). We measured pyruvate, lactate, acetoacetate (AcAc) and 3-hydroxybutyrate (3OHBA) while monitoring hemodynamics and blood gases, and calculated pyruvate/lactate and AcAc/3OHBA ratios. There was no statistically significant difference between the two groups in hemodynamic parameters, except for stroke volume index, and oxygen consumption throughout this experiment. Arterial pH and base excess increased significantly in the NaHCO3 group. The increases of pyruvate and lactate were significantly greater in the NaHCO3 group than in the NaCl group, but the other metabolic data were not significantly different. We did not find that NaHCO3 had greater beneficial effect than NaCl in hemorrhagic shock model, and the use of NaHCO3 for LA due to hemorrhagic shock may not be recommended.
最近的几项研究评估了碱疗法治疗乳酸性酸中毒(LA)的效果。我们研究了碳酸氢钠(NaHCO₃)对犬失血性休克所致LA的影响。在诱导12只杂种犬发生失血性休克后,我们将它们分为两组:第一组用7%的NaHCO₃治疗,第二组用4.9%的氯化钠(NaCl)治疗。我们在监测血流动力学和血气的同时测量丙酮酸、乳酸、乙酰乙酸(AcAc)和3-羟基丁酸(3OHBA),并计算丙酮酸/乳酸和AcAc/3OHBA比值。在整个实验过程中,除了每搏量指数和氧耗外,两组的血流动力学参数没有统计学上的显著差异。NaHCO₃组的动脉pH值和碱剩余显著升高。NaHCO₃组丙酮酸和乳酸的升高显著大于NaCl组,但其他代谢数据没有显著差异。我们发现在失血性休克模型中,NaHCO₃并不比NaCl有更大的有益作用,因此不建议将NaHCO₃用于治疗失血性休克所致的LA。