Effect of alkalinization and fluids on survival in acute, non-hypoxic respiratory acidosis

Effects of intravenous normal saline, sodium bicarbonate, hypertonic saline, and Tromethamine were studied in 21 pigs and 60 rats subjected to acute, severe respiratory acidosis. Transient multiphasic alterations of systemic arterial pressures were seen with boluses of each agent-especially sodium bicarbonate and hypertonic saline-but any improvements in hemodynamic variables were transient. At the dose given, sodium bicarbonate significantly increased PaCO2 while decreasing hydrogen ion (H+) accumulation, whereas tromethamine buffered pH without significantly increasing PaCO2. However, no change of either arterial or venous H+ or PCO2 could be identified which rapidly produced death. Survival times were statistically equivalent among all groups. Therefore, intravenous treatment of respiratory acidosis with fluids or alkalinizing agents appears neither helpful nor harmful.