EVIDENCE FOR A DETRIMENTAL EFFECT OF BICARBONATE THERAPY IN HYPOXIC LACTIC-ACIDOSIS
EVIDENCE FOR A DETRIMENTAL EFFECT OF BICARBONATE THERAPY IN HYPOXIC LACTIC-ACIDOSIS
复制标题
DOI：
10.1126/science.3969564
复制
发表时间：
1985-01-01
期刊：
影响因子：
56.9
通讯作者：
ARIEFF, AI
中科院分区：
文献类型：
--
作者：
GRAF, H;LEACH, W;ARIEFF, AI
乳酸酸中毒是由乳酸蓄积引起的一种临床综合征，其特征是血中乳酸浓度<5 mM。治疗通常包括静脉注射。碳酸氢钠(NaHCO3)，但由此导致的死亡率为60%。本文研究了NaHCO3治疗犬缺氧性乳酸中毒的代谢和全身效应，并与NaC l或NO治疗进行了比较。NaHCO3提高血乳酸浓度的程度比氯化钠或不处理的程度更大。尽管注入了碳酸氢钠，但三组狗的动脉pH值和碳酸氢钠浓度都下降了相似的幅度。观察到NaHCO3对心血管系统的其他有害影响，包括心输出量和血压的下降，这在氯化钠或不治疗的情况下都没有观察到。因此，有证据表明NaHCO3在治疗缺氧性乳酸酸中毒中有有害作用。
Lactic acidosis, a clinical syndrome caused by the accumulation of lactic acid, is characterized by lactate concentration in blood > 5 mM. Therapy usually consists of i.v. sodium bicarbonate (NaHCO3), but resultant mortality is > 60%. The metabolic and systemic effects of NaHCO3 therapy of hypoxic lactic acidosis in dogs were studied and compared to the effects of NaCl or no therapy. NaHCO3 elevated blood lactate concentrations to a greater extent than did either NaCl or no treatment. Despite the infusion of NaHCO3, both arterial pH and bicarbonate [HCO3] concentration decreased by a similar amount in all 3 groups of dogs. Additional detrimental effects of NaHCO3 were observed on the cardiovascular system, including decreases in cardiac output and blood pressure that were not observed with either NaCl or no treatment. Thus there is evidence for a harmful effect of NaHCO3 in the treatment of hypoxic lactic acidosis.