Rapid infusion of sodium bicarbonate and albumin into high-risk premature infants soon after birth: a controlled, prospective trial.

TitleRapid infusion of sodium bicarbonate and albumin into high-risk premature infants soon after birth: a controlled, prospective trial.
Publication TypeJournal Article
Year of Publication1976
AuthorsBland RD, Clarke TL, Harden LB
JournalAm J Obstet Gynecol
Volume124
Issue3
Pagination263-7
Date Published1976 Feb 1
ISSN0002-9378
KeywordsAcidosis, Albumins, Bicarbonates, Carbon Dioxide, Cerebral Hemorrhage, Female, Hawaii, Humans, Hydrogen-Ion Concentration, Infant, Newborn, Infant, Premature, Diseases, Infusions, Parenteral, Male, Prospective Studies, Respiratory Distress Syndrome, Newborn, Sodium, Time Factors
Abstract

We conducted a controlled, prospective trial to evaluate the effectiveness of rapidly infusing sodium bicarbonate (NaHCO3) and salt-poor albumin into high-risk, premature infants in the first 2 hours of life. Fifty-three infants, randomized into one of four treatment groups, received 8 ml. per kilogram of a solution containing either (A) glucose in water, (B) salt-poor albumin, (C) NaHCO3, or (D) a combination of albumin and NaHCO3. After the initial infusion, the babies received no colloid or alkali solutions until 4 hours of age. We managed them supportively with warmth, appropriate oxygen administration, isotonic fluid infusion, and close monitoring. Among the infants who received alkali, 14 of 26 acquired the respiratory distress syndrome (RDS), 11 died, and four had intracranial hemorrhage. Among babies who received no alkali, RDS occurred in 11 of 27, 5 died, and none had intracranial hemorrhage. These results do not support the common practice of rapidly infusing NaHCO3 into high-risk, premature infants, and they suggest that the early management of such infants needs renewed critical evaluation.

Alternate JournalAm. J. Obstet. Gynecol.
PubMed ID2013
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