Background Still exist controversies about sodium bicarbonate (SB) effectiveness in metabolic acidosis (MA). The SB dose finally remain at discretion of physician.
Aims Proving SB efficiency in severe acute dehydration (SAD) with MA secondary to acute diarrhoea (AD) in children.
Methods Retrospective study conducted between May–September 2013, in 0–5 years old patients hospitalised for AD with SAD and MA. We chose the propitious age group and season for acute gastrointestinal pathology. We considered SAD loss >10% of body weight and severe MA pH <7,2 and bicarbonate <15 mmol/L. Not included patients with associated pathology. Were studied 43 medical records; blood gases (BG) assessed at admission, 1 h (1H) and 4 h (4H). 31 patients received SB (7–2meq/kg dose – A Group, 24–1 meq/kg – B Group) and 12 not (C Group).
Results In A Group, at admission, 57,14% presented pH <7,2, 100% bicarbonate <15; at 1 H, all presented normal pH and bicarbonate >15; at 4 H, all presented alkalosis. In B Group, at admission, 50% presented severe MA; at 1 H, 25% presented alkalemia, 50% bicarbonate <15; at 4 h, 25% presented alkalosis. In C Group, at admission, 50% presented bicarbonate <15; starting with 1 H, 91,66% presented normal BG.
86,04% presented respiratory compensation (RC), pCO2 around 20 mmHg. Percentage of patients which developed alkalosis was significantly greater in A than B Group (p 0,004); no significance between C and B Group (p 0,57).
Conclusions In choosing the bicarbonate dose in metabolic acidosis, the physician should consider also the RC, especially at 2 meq/kg dose.