Importance of tonicity of carbicarb on the functional and metabolic responses of the acidotic isolated heart.

In this study, the physiological and metabolic effects of Carbicarb administered as an isotonic (150 mmol/L Na[n[]I+) or hypertonic (1 mol/L Na[n[]I+) solution over 2 minutes in the acidotic isolated heart were compared. Physiological monitoring as well as 31P and 23Na nuclear magnetic resonance spectroscopy were performed. Both isotonic and hypertonic Carbicarb induced comparable dose-dependent increases in intracellular pH as well as decreases in inorganic phosphate and increases in creatine phosphate concentrations, which were sustained for 20 minutes. However, immediate functional improvement was greater in hearts receiving isotonic Carbicarb. Metabolic acidosis conditions resulted in a 27% increase in cytosolic sodium by 30 minutes (P < .05). In this setting, hypertonic Carbicarb induced a large transient increase in cytosolic sodium, whereas isotonic Carbicarb caused immediate and sustained decreases in cytosolic sodium. These data suggest that isotonic Carbicarb may have more beneficial effects on cardiac function than hypertonic Carbicarb. These effects may be related to associated changes in cytosolic sodium.