Mixture Of Sodium Bicarbonate Research Articles

Haemodynamic and metabolic effects in diabetic ketoacidosis in rats of treatment with sodium bicarbonate or a mixture of sodium bicarbonate and sodium carbonate

To examine factors determining the haemodynamic and metabolic responses to treatment of diabetic ketoacidosis with alkali, groups of anaesthetised and ventilated rats with either diabetic ketoacidosis (mean arterial pH 6.86–6.96, mean arterial blood pressure 63–67 mm Hg) or hypovolaemic shock due to blood withdrawal (mean pHa 7.25–7.27, mean arterial blood pressure 36–41 mmHg) were treated with sodium chloride (‘saline’), sodium bicarbonate or ‘Carbicarb’ (equimolar bicarbonate plus carbonate). In the diabetic ketoacidosis series, treatment with either alkali resulted in deterioration of mean arterial blood pressure and substantial elevation of blood lactate, despite a significant rise in myocardial intracellular pH determined by 31P-magnetic resonance spectroscopy. These effects were accompanied by falling trends in the ratios of myocardial phosphocreatine and ATP to inorganic phosphate. Erythrocyte 2,3-bisphosphoglycerate was virtually absent in animals with diabetic ketoacidosis of this severity and duration. In contrast, in shock due to blood withdrawal, infusion of saline or either alkali was accompanied by a transient elevation of mean arterial blood pressure and no significant change in the already elevated blood lactate; erythrocyte 2,3-bisphosphoglycerate was normal in these animals. The effect of alkalinization in rats with severe diabetic ketoacidosis was consistent with myocardial hypoxia, due to the combination of very low initial erythrocyte 2,3-bisphosphoglycerate, alkali-exacerbated left shift of the haemoglobin-oxygen dissociation curve and artificial ventilation. No evidence was found for any beneficial effect of ‘Carbicarb’ in either series of animals; ‘Carbicarb’ and sodium bicarbonate could be deleterious in metabolic acidosis of more than short duration.

The effects of sodium bicarbonate and a mixture of sodium bicarbonate and carbonate (“Carbicarb”) on skeletal muscle pH and hemodynamic status in rats with hypovolemic shock

Rats rendered hypotensive and acidotic by withdrawal of blood were treated by infusion of either an equimolar mixture of sodium bicarbonate and sodium carbonate (“Carbicarb”), sodium bicarbonate alone, or sodium chloride. Skeletal muscle intracellular pH (pH i) was measured using magnetic resonance spectroscopy from the chemical shift of the carbon-2 (C2) proton resonance of the imidazole ring of anserine. In the groups treated with alkali, arterial blood pH (pH a) was restored to normal, but no change was observed in the sodium chloride-treated animals. Despite an elevation of arterial blood partial pressure of CO 2 (P a co 2 ) in the group treated with sodium bicarbonate, no significant change in pH i was observed in any group. Blood lactate levels, initially elevated in all groups, underwent only minor changes. In all three groups a transient and similar elevation of arterial blood pressure was observed after infusion. Differential effects of Carbicarb and sodium bicarbonate in metabolic acidosis may be dependent on the model of metabolic acidosis used, and an alteration in Pa co 2 induced by alkali therapy may not be a major determinant of changes in pH i.

Buffer Solutions May Compromise Cardiac Resuscitation by Reducing Coronary Perfusion Pressure

--To investigate the effects of hypertonic buffer solutions on coronary perfusion pressure (CPP) and resuscitability during experimental closed-chest cardiac resuscitation. --Randomized, placebo-controlled trial. --Mammalian research laboratory. --Forty-four domestic pigs. --Cardiac arrest was induced by ventricular fibrillation in mechanically ventilated pigs anesthetized with pentobarbital sodium. Precordial compression was started at the third minute of untreated ventricular fibrillation and maintained for an interval of 8 minutes. A hypertonic solution of sodium bicarbonate, Carbicarb (an equimolar mixture of sodium bicarbonate and sodium carbonate [International Medication Systems, Ltd]), or sodium chloride or an isotonic solution of sodium chloride was infused into the right atrium over a 1-minute interval starting at the sixth minute of ventricular fibrillation. Restoration of spontaneous circulation was attempted by DC transthoracic countershock after 11 minutes of ventricular fibrillation. --Plasma osmolality, CPP, and cardiac resuscitability. --Infusion of hypertonic buffer and sodium chloride solutions increased plasma osmolality from an average of 280 to 330 mOsm/kg. This was accompanied by a significant decrease in the aortic pressures and CPPs generated during precordial compression. No such changes occurred after infusion of isotonic sodium chloride. Restoration of spontaneous circulation, as in earlier studies, was contingent on the levels of CPP prior to attempted defibrillation. Accordingly, none of 13 animals in which the CPP declined to less than 10 mm Hg after infusion of the hypertonic solutions were successfully resuscitated. This contrasted with nine animals that received isotonic sodium chloride and served as controls. Coronary perfusion pressure consistently exceeded 10 mm Hg in these control animals, and spontaneous circulation was restored in each instance. --Hypertonic solutions and specifically buffer solutions administered in the absence of vasopressor agents may adversely affect cardiac resuscitation efforts by reducing CPP below critical thresholds.

Salt-sensitive hypertension: contribution of chloride.

The effect of the anion associated with sodium loading on the development of hypertension in the Dahl salt-sensitive rat was determined. For 5 weeks rats were fed a diet containing normal or high concentrations of sodium chloride or high concentrations of sodium provided as a mixture of sodium bicarbonate, phosphate, and amino acids. After 1 week on these diets and until the end of the study the rats receiving high concentrations of sodium chloride had higher systolic blood pressures than the rats in the other two groups. There were no statistically significant group differences in plasma volume, arterial pH, or plasma concentrations of Na+, K+, Cl-, Ca2+, or creatinine, or in renomedullary prostaglandin E2 production. Compared to the animals receiving normal concentrations of sodium chloride, those receiving high concentrations of sodium chloride or amino acids showed decreased plasma renin activity and plasma aldosterone concentrations. Thus, the anion ingested with sodium alters the development and severity of hypertension in the Dahl salt-sensitive rat.

Improved Assay of Mixtures of Sodium Bicarbonate and Sodium Citrate in Antacid Preparations

Abstract A method involving ion-exchange chromatography and titration was developed. A diluted sample was run through a cation-exchange resin column. After the eluate was boiled, it was titrated with 0.02 N NaOH to find the sodium citrate content (Titration I). An equal volume of the diluted sample was eluted through an anion-exchange resin column and the eluate was titrated with 0.02 N HCl to assay for total sodium bicarbonate and sodium citrate (Titration II). Subtracting the result of Titration I from that of Titration II, gave the sodium bicarbonate content. The cation-exchange chromatography step was validated previously. The anion-exchange chromatography step was validated by assaying pure sodium bicarbonate and sodium citrate separately. The overall percent recoveries (+ SD) were 98.9 + 0.2% for sodium citrate and 98.1 + 0.1% for sodium bicarbonate (n = 3). Average percent recoveries (+ SD) from synthetic mixtures of the two salts were (n = 4): 99.3 + 0.5% for sodium citrate and 98.0 + 1.2% for sod...

Two New Standards for the pH Scale.

Two new primary standards for the NBS pH scale, supplementing the five already available, are proposed. The new reference solutions are the 0.05 molal solution of potassium dihydrogen citrate and a mixture of sodium bicarbonate and sodium carbonate, each 0.025 molal. The citrate solution has a pH of 3.776 at 25 °C and is more stable under certain conditions than either the tartrate or phthalate standards. The carbonate solution has a pH of 10.012 at 25 °C. It therefore extends the NBS pH scale above its present upper limit of 9.180 at this temperature. Reference values pH(S), based on emf measurements of cells with hydrogen electrodes and silver-silver chloride electrodes, have been assigned to these two standard solutions at 11 temperatures from 0 to 50 °C.

THE ADDITION OF BUFFERS TO RUMINANT RATIONS: I. EFFECT ON WEIGHT GAINS, EFFICIENCY OF GAINS AND CONSUMPTION OF RATIONS WITH AND WITHOUT ROUGHAGE

A total of sixty-eight beef steers were used in three feeding trials to determine the effects of adding buffers to ruminant rations. The buffers used in these trials were sodium propionate and mixtures of sodium bicarbonate, potassium carbonate and calcium carbonate (as ground limestone). They were fed at levels varying from 2 to 9 pounds per 100 pounds of the concentrate ration. Data on feed consumption, weight gains and efficiency of feed conversion are presented.The addition of buffers to a ration containing timothy hay fed ad libitum did not prove beneficial. Buffers at the highest level (9 pounds per 100 pounds) were detrimental in the hay-concentrate ration. When the hay was removed from the ration there were highly significant decreases in weight gains and T.D.N. consumption. These decreases were partially offset by the addition of buffers to the all-concentrate rations. The results may have a practical application in the feeding of low-roughage rations.

The prevention of edema in infants undergoingsulfonamide treatment

I T HAD been noted for some time at the Children's Hospital that infants treated sulfonamides and adjuvant alkalies became edematous more often than might be expected from the incidence of pulmonary infections. Upon closer examination it was noted that even in the absence of frank pitting edema, many other infants made precipitous and appreciable weight gains, which were as rapidly lost upon recovery and cessation of therapy. It has long been a wellrecognized observation that patients pneumonia very frequently became edematous and a diuresis was hailed as the first sign of recovery. However, the advent of the sulfonamides this was noted more often in pulmonary infections and also, interestingly enough, was seen in other infections. The alkali in general use in the Children's Hospital, as elsewhere, was sodium bicarbonate. Because of the well-known importance of the sodium ion in water balance, it was decided to see whether the edema could be prevented by using alkalies with cations other than the sodium ion. Potassium citrate was chosen because of its high solubility and availability at the time. Without selection, alternating admissions requiring sulfonamide therapy were given either sodium bicarbonate or potassium citrate. The dosage of the sodium bicarbonate ranged from 0.28 to 0.42 Gin. per kilogram. The dose of potassium citrate ranged between 0.44 to 0.70 Gin. per kilogram. In the administration of the drugs the larger doses were given the smaller infants. After this series, a group of children were given a mixture of sodium bicarbonate and potassium citrate. This mixture contained .066 Gm. of potassium citrate and .033 Gm. of sodium bicarbonate in each cubic centimeter. The average dose was 0.42 Gin. of potassium citrate and 0.21 Gm. of sodium bicarbonate per kilogram of body weight. This mixture was used in an attempt to lessen the theoretical chances of toxicity due to the potassium ion and at the same time to obviate the production of edema due to excess sodium. A fourth group was given 10 per cent sodium lactate in dosage of 0.48 Gm. per kilogram of body weight as the alkalinizing agent. The apparent discrepancies in amount of alkali used do not really exist. This is made clear by stating the dosage in moles of cation used per kilogram of body weight. Examples of this are given in Table I. All the alkalies were given by mouth. Very few children were unable to take them in this manner. These infrequent patients are customarily given parenteral one-sixth molar sodium lactate. The pH of the urine was measured nitrazine paper three times a day. All the alkalies tried, in the dosages given, satisfactorily kept the pH of the urine between 7 and 7.5 or better,