Effects of Carbicarb™ and Sodium Bicarbonate on Hypoxic Lactic Acidosis in Newborn Pigs

Abstract

Background

Use of sodium bicarbonate (NaHCO₃) may result in intracellular acidosis due to the generation of CO₂. Carbicarb, has been reported to be superior to sodium bicarbonate (NaHCO₃) because of lesser generation of CO₂. The present study was designed to investigate whether Carbicarb or NaHCO₃ is superior to normal saline in the treatment of hypoxic lactic acidosis.

Methods

Hypoxia was induced by ventilation with 8% O2 in 30 piglets with fixed ventilation. When the pH fell to < 7.2, hypoxia was reversed by placing the animals in 21% O2 (experiment 1) or 100% O2 (experiment 2) and either saline, Carbicarb or NaHCO₃ were given. Data were collected for 120 minutes after therapy.

Results

In both experiment 1 (severe acidosis, pH < 7.1) and 2 (moderate acidosis, pH < 7.2) use of Carbicarb and NaHCO₃ increased the arterial carbon dioxide tension (pCO₂) significantly (p < 0.05). With moderate acidosis: 1) use of alkalinizing agents compared to saline resulted in an initial improvement in arterial pH at 1 minute, but thereafter, the differences were not statistically significant; and 2) there were no differences in hemodynamic variables and plasma lactic acid concentration between the three groups.

Conclusions

The data demonstrate that 1) both Carbicarb and NaHCO₃ significantly increase arterial pCO₂; and 2) use of either alkalinizing agent in moderate acidosis does not alter the course of acidosis.