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Impact of sodium bicarbonate therapy on hemodynamic parameters in infants: a meta-analysis

Rohit S Loomba1, Mubeena Abdulkarim1, Ronald A Bronicki2

  • 1Division of Cardiology, Chicago Medical School, Advocate Children's Hospital, Chicago, IL, USA.

The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
|July 7, 2020
PubMed

Insights

Sodium bicarbonate improved base deficit and carbon dioxide levels in critically ill infants. However, these changes were not clinically significant, with no impact on other vital signs or oxygenation.

Area of Science:

  • Pediatric Critical Care Medicine
  • Neonatology
  • Pediatric Emergency Medicine

Background:

  • Metabolic acidosis is common in critically ill children.
  • Sodium bicarbonate is frequently used to treat metabolic acidosis.
  • Its effects on hemodynamics, gas exchange, and oximetry in this population require clarification.

Purpose of the Study:

  • To systematically review and meta-analyze the effects of sodium bicarbonate on hemodynamics, gas exchange, and oximetry in critically ill children with metabolic acidosis.

Main Methods:

  • Systematic review of published studies involving children treated with sodium bicarbonate for metabolic acidosis.
  • Meta-analysis to assess the impact on base deficit, heart rate, mean arterial pressure, carbon dioxide levels, pH, and pulse oximetry.

Main Results:

  • Six studies with 341 critically ill infants (mean age 1.1 months) were included.
  • Sodium bicarbonate administration (mean dose 1.7 meq/kg) significantly improved base deficit (decrease of 2.80) and decreased partial pressure of carbon dioxide (-1.65 mmHg).
  • No significant changes were observed in heart rate, mean arterial pressure, pH, partial pressure of oxygen, or pulse oximetry saturation.

Conclusions:

  • Sodium bicarbonate shows statistically significant but not clinically significant improvements in base deficit and carbon dioxide levels in critically ill infants.
  • No discernible impact on pH, oxygenation, or hemodynamics was noted within 60 minutes of administration.
Abstract

Keywords:
Sodium bicarbonateacidosiscritical carehemodynamicpediatrics

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