Table 1.
Study | Experimental (E) or human (H) | Methodology (intervention/subjects/protocol/measurements) | Increased PaCO 2 after alkalinization in HCO 3 − group? | Decreased or unchanged pHe or pHi after alkalinization in HCO 3 − group or compared with other groups? | Shock associated lactic acidosis? | Positive effects of sodium bicarbonate on hemodynamics (arterial pressure/ cardiac index) a | Positive impact of sodium bicarbonate on mortality b |
---|---|---|---|---|---|---|---|
Kim et al . 2013 [112] | H | Retrospective. 103 patients with lactic acidosis. Effects of HCO3 − on survival | NA | NA | Yes | NA | NA |
Wilson et al . 2013 [81] | H | Retrospective series. Severe acidotic trauma patients. Effects of HCO3 − on survival, PaCO2, pH | Yes | pHe: no | Yes | NA | NA |
pHi: NA. | |||||||
Levraut et al . 2000 [113] | H | Mild metabolic acidosis in non-shock patients. Effects of a bicarbonate load on CO2 generation depending on non-bicarbonate buffer | Yes | pHe: no | No | NA | NA |
pHi: no | |||||||
Nielsen et al . 2002 [114] | H | 5-minute rhythmic handgrip to provoke intracellular acidosis. Healthy subjects. HCO3 − vs. saline. Effect on arterial pH, and muscle pHi, PaCO2 | Yes | pHe: no | No | NA | NA |
pHi: no | |||||||
Nakashima et al . 1996 [115] | H | Healthy subjects. Effects of HCO3 − infusion on cerebral blood flow, PaCO2 and pHi | Yes | pHe: no | No | NA | NA |
pHi: yes | |||||||
Leung et al . 1994 [100] | H | Metabolic acidosis in patients undergoing surgery. HCO3 − vs. carbicarb. Effects on pHe, hemodynamics | NA | pHe: no | No | No | NA |
pHi: NA | |||||||
Mark et al . 1993 [116] | H | Intraoperative mild acidosis. HCO3 − vs. saline. Effects on PaCO2, pH, hemodynamics | Yes | pHe: no | No | NA | NA |
pHi: NA | |||||||
Fanconi et al . 1993 [117] | H | Neonatal acidosis. HCO3 − before-after study. Effect on hemodynamics, pH, PaCO2, PtCO2 | Yes | pHe: no | Yes | Yes | NA |
pHi: NA | |||||||
Mathieu et al . 1991 [92] | H | Septic shock. HCO3 − vs. saline. Effect on arterial pH, PaCO2, hemodynamics | Yes | pHe: no | Yes | No | NA |
pHi: NA | |||||||
Cooper et al . 1990 [89] | H | Septic shock. HCO3 − vs. saline. Effect on arterial pH, PaCO2, hemodynamics | Yes | pHe: no | Yes | No | NA |
pHi: NA | |||||||
Bersin et al . 1989 [118] | H | Congestive heart disease. HCO3 − vs. saline. Effect on acidosis, PaCO2, hemodynamics (myocardial oxygen consumption) | Yes | pHe: no | No | No | NA |
pHi: NA | |||||||
Kimmoun et al . 2014 [60] | E | Hemorrhagic shock. Rats. HCO3 − with calcium adjunction and increased respiratory rate. Effect on pHe, muscle pHi, hemodynamics | No | pHe: No | Yes | Yes | NA |
pHi: No | |||||||
Valenza et al . 2012 [84] | E | Lactic acid infusion. Rats. Lactic acidosis vs. lactic acidosis + sodium bicarbonate. Effects on hemodynamics, pHe, lactate, phosphofructokinase. | Yes | pHe: No | No | No | NA |
pHi: NA | |||||||
Beech et al . 1994 [87] | E | Hypovolemic shock. Rats. Carbicarb vs. HCO3 −. Muscle pHi, PaCO2 and hemodynamics | Yes | pHe: No | Yes | No | NA |
pHi: Yes | |||||||
Bollaert et al . 1994 [79] | E | Endotoxinic shock. Rats. HCO3 − vs. saline. Effect on arterial pH, PaCO2, muscle pHi, hemodynamics | Yes | pHe: No | Yes | No | NA |
pHi: Yes | |||||||
Rhee et al . 1993 [83] | E | Hypoxic lactic acidosis. Mongrel dogs. HCO3 − vs. Carbicarb vs. saline. Effects on PaCO2, hemodynamics | Yes | pHe: Yes | Yes | No | NA |
pHi: Yes | |||||||
Cooper et al . 1993 [88] | E | L-lactic infusion. Pigs. HCO3 − vs. saline. Effects on pH, hemodynamics | Per protocol ventilation adjustment | pHe: No | Yes | No | NA |
pHi: NA. | |||||||
Shapiro et al . 1990 [119] | E | Ammonium chloride-induced metabolic acidosis. HCO3 − vs. Carbicarb. Effects on PaCO2, pHe, hepatic pHi, hemodynamics | Yes | pHe: No | No | No | NA |
pHi: Yes | |||||||
Dimlich et al . 1988 [120] | E | Low-flow-induced lactic acidosis. Rats. HCO3 − vs. NaDCA vs. NaCl. Effects on pH, lactatemia | NA | pHe: No | Yes | No | NA |
pHi: NA. | |||||||
Iberti et al . 1988 [91] | E | Hemorrhagic shock. Dogs. HCO3 − vs. saline. Effect on hemodynamics, pH, PaCO2 | Yes | pHe: Yes | Yes | No | NA |
pHi: NA. | |||||||
Hope et al . 1988 [121] | E | Incomplete cerebral ischemia in lamb. Effects of glucose and HCO3 − on cerebral pHi, PaCO2 and PtiCO2 | Yes | pHe: No | No | NA | NA |
pHi: Yes | |||||||
Sessler et al . 1987 [122] | E | Lactic acidosis treatment in neonatal rabbits. Effect of HCO3 − on pHi and pHe and PaCO2 | Yes | pHe: no | Yes | NA | NA |
pHi: no | |||||||
Graf et al . 1985 [90] | E | Hypoxic lactic acidosis. Dogs. HCO3 − vs. saline vs. no therapy. Effects on pHe and hemodynamics | NA | pHe: yes | Yes | No | No |
pHi: NA | |||||||
Graf et al . 1985 [123] | E | Hypoxic lactic acidosis. Dogs. HCO3 − vs. saline. Effects on pHe and hepatic pHi | Yes | pHe: yes | Yes | No | No |
pHi: yes | |||||||
Arieff et al . 1982 [82] | E | Phenformin-induced lactic acidosis. Dogs. HCO3 − vs. saline vs. placebo. Effects on pHe, pHi, hemodynamics | NA | pHe: yes | Yes | No | No |
pHi: yes |
aOnly applicable in comparative studies with critical patients or experimental models. bOnly applicable in comparative studies with critical patients or experimental models. NA, not applicable; pHe, extracellular pH; pHi, intracellular pH.