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Disadvantages of Overcorrecting Acidemia in Cardiopulmonary Resuscitation

Published online by Cambridge University Press:  17 February 2017

G.H. Meuret  and
M. Mussler
G.H. Meuret
Affiliation:
Institute for Anesthesiology, Hugstetterstrasse 55, University of Freiburg, Freiburg im Breisgau, West Germany
M. Mussler
Affiliation:
Institute for Anesthesiology, Hugstetterstrasse 55, University of Freiburg, Freiburg im Breisgau, West Germany
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Extract

Rapid and repeated administration of concentrated NaHCO3 solutions during cardiopulmonary resuscitation (CPR) has become routine since the advent of modern resuscitation techniques (1), although it has been pointed out since the early 1960s that acidemia results from prolonged arrest time and that brief arrests may not require NaHCO3 administration (6,8,13). In spite of the widespread use of large amounts of NaHCO3 there is no convincing evidence that the routine use of this drug offers a clear benefit. Only a few studies have been undertaken to ascertain the role of acidosis and acidemia in survival from cardiac arrest, and the possibility of overcorrecting with NaHCO3 in CPR cases (3,4,8,11). Therefore, the intention of this study was: 1) to clarify the role of acidemia in CPR; 2) to investigate the effects of overcorrection of acidemia (leading to metabolic alkalemia; 3) to test the accurate doses of NaHCO3; 4) to examine the optimal sequence of drug administration in CPR, i.e., whether NaHCO3 or epinephrine should be administered as the first drug.

During attempts at restoring spontaneous circulation (CPCR Phase II, advanced life support) (12), and during post-CPR prolonged life support (CPCR Phase III) (12), measurements were made in dogs following resuscitation from asphyxial cardiac arrest. The model and methods used have been described in the preceding paper of this Journal. Asphyxial cardiac arrest (mechanical asystole, electromechanical dissociation) was reversed with open-chest CPR and defibrillation as necessary to 20 min max.

Type
Section Two—Clinical Topics
Information
Prehospital and Disaster Medicine , Volume 1 , Issue 3 , Fall 1985 , pp. 229 - 236
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1985

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