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Clinical evaluation of sodium bicarbonate, sodium L-lactate, and sodium acetate for the treatment of acidosis in diarrheic calves.

Thirty-six dehydrated diarrheic neonatal calves were used to study the effects of various alkalinizing compounds on acid-base status, the changes in central venous pressure (CVP) in response to rapid IV infusion of large volumes of fluid, and the correlation of acid-base (base deficit) status, using a depression scoring system with physical determinants related to cardiovascular and neurologic function. Calves were allotted randomly to 4 groups (9 calves/group). Over a 4-hour period, each calf was given two 3.6-L volumes (the first 3.6 L given in the first hour) of a polyionic fluid alone (control group) or were given the polyionic fluid with sodium bicarbonate, sodium L-lactate, or sodium acetate added (50 mmol/L). Acid-base status, hematologic examination, and biochemical evaluations were made immediately before infusion of each fluid (at entry) and after 3.6, 4.8, and 7.2 L of fluid had been given. Compared with control values, bicarbonate, lactate, and acetate had significantly greater alkalinizing effects on pH (P less than 0.01) and base deficit (P less than 0.01) after 3.6, 4.8, and 7.2 L of fluid were given. Bicarbonate had the most rapid alkalinizing effect and induced greater changes in base deficit (P less than 0.01) than did acetate or lactate at each of the 3 administered fluid volumes evaluated. Acetate and lactate had similar alkalinizing effects on blood. Rehydration alone did not improve acid-base status. The CVP was elevated in 10 (28%) of the 36 calves after 1 hour of fluid (3.6 L) administration, but significant differences in body weight, PCV, and clinical condition or depression score at entry were not found between calves with elevated CVP and those with normal CVP.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetates↗

[Application of a paste composed of sodium bicarbonate, sodium chloride and hydrogen peroxide in treating of active periodontal pockets].

Close relationship existing between dentobacterial plaque and chronic inflammatory periodontal disease, as well as effectiveness of conservative treatments used to eliminate chronic gingivitis, is wordly known. However, several years ago, chronic destructive periodontal disease was only solved by surgical techniques, most of them bloody and of doubtful solution for some periodontal problems; for such reasons, a study was carried out in order to learn about the role played by a medicament formed with sodium bicarbonate, sodium chloride and hydrogen peroxide, deeply applied as a paste into active periodontal pockets, after an exquisite open radicular planing. Results obtained point out that the use of this procedure effective in the therapy of chronic inflammatory periodontal disease.

Adult↗

Dietary mixtures of sodium bicarbonate, sodium chloride, and potassium chloride: effects on lactational performance, acid-base status, and mineral metabolism of Holstein cows.

The objective of this study was to determine lactational, blood mineral, and blood acid-base responses to dietary mixtures of NaHCO3, NaCl, and KCl and dietary cation-anion difference by lactating diary cows. Three 100:0:0 (primary) blends, three 50:50:0 (binary) blends, and one 33:33:33 (tertiary) blend of NaHCO3, NaCl, and KCl, respectively, were formulated to replace 1% of the dry matter in a diet based on corn silage. Seven treatments were defined according to a simplex-centroid mixtures design using a partially balanced incomplete block arrangement. An eighth treatment served as a control and contained 1% SiO2 instead of the mineral blends. Dietary cation-anion difference ranged from +25 to +40 meq of (Na + K - Cl)/100 g of dietary dry matter. Diets were fed for three consecutive 28-d periods during summer to 36 midlactation cows. Cows that were fed the tertiary mixture had lower milk protein percentage, whole blood bicarbonate, and plasma K than did cows fed the other blends. With the exception of milk protein percentage and body weight gain, none of the mixtures had a significant impact on lactational performance. The lack of differences could have been due to the narrow range in the dietary cation-anion difference studied.

Acid-Base Equilibrium↗

[Precipitation of pH-adjusted local anesthetics with sodium bicarbonate].

Sodium bicarbonate has been added to various local anesthetics for shortening the onset time. We often noticed the precipitate in the pH-adjusted local anesthetics several minutes after adding the bicarbonate. We confirmed that this drug interaction was caused by large changes in pH. We have analyzed the precipitates by mass spectrometry and infrared absorption spectrum and have revealed it as unionized base forms of local anesthetics. Since these forms tend to be insoluble, we must limit the amount of 7% sodium bicarbonate. This study proposes a guideline for adding 7% sodium bicarbonate to the various local anesthetics. The amount of 7% sodium bicarbonate which can be added to bupivacaine without precipitation is below 0.02 ml. In cases of mepivacaine and lidocaine, allowable amount of 7% sodium bicarbonate is 0.5 ml. It is not known whether this lower dose of 7% sodium bicarbonate compared with the recent reports is effective or not. Further clinical investigation may be necessary.

Anesthetics, Local↗

Carbicarb, sodium bicarbonate, and sodium chloride in hypoxic lactic acidosis. Effect on arterial blood gases, lactate concentrations, hemodynamic variables, and myocardial intracellular pH.

The effects of Carbicarb, sodium bicarbonate, and sodium chloride on arterial blood gases, lactate concentrations, hemodynamics, and myocardial intracellular pH were compared in hypoxic lactic acidosis with controlled carbon dioxide elimination. Twenty-one young mongrel dogs were anesthetized, mechanically ventilated, and randomly allocated into one of three treatment groups. After hypoxic lactic acidosis was induced and maintained, 2.5 mEq/kg of one of the agents was infused over 30 min. Arterial blood gases, pH, lactate concentrations, and hemodynamic variables were measured immediately prior to the infusion of the agent and 30 min after the infusion was completed. With sodium bicarbonate administration, there was a significant increase in arterial PCO2 as compared to both Carbicarb or sodium chloride administration. With Carbicarb administration, there was a significant increase in arterial pH, base excess, and cardiac index, without a significant increase in arterial lactate concentration as compared to sodium bicarbonate or sodium chloride administration. Stroke volume index was also increased significantly with decreased heart rate. The data suggest that Carbicarb administration in hypoxic lactic acidosis improved hemodynamics compared with sodium bicarbonate or sodium chloride administration. The increased stroke volume and cardiac contractility appear to be due to improved myocardial intracellular pH.

Acidosis, Lactic↗

Comparative effects of sodium bicarbonate and sodium chloride on reversing cocaine-induced changes in the electrocardiogram.

Cocaine abuse is associated with a number of cardiovascular complications that include arrhythmias and sudden cardiac death. Although the mechanism(s) remain unclear, cocaine-induced block of sodium channels resulting in slowed cardiac conduction is thought to play an important role. Several reports suggest that the effects of cocaine effects on cardiac sodium channels can be reversed by administration of sodium bicarbonate. Whether the beneficial effects of sodium bicarbonate are due to sodium ions or an increase in blood pH is unknown. Therefore the purpose of this study was to compare the effects of sodium loading alone (by using sodium chloride) versus sodium loading with an associated increase in arterial pH (by using sodium bicarbonate) on reversing cocaine-induced effects on the electrocardiogram (ECG) in a canine model. Seventeen anesthetized dogs received three i.v. injections of cocaine, 5 mg/kg, with each dose separated by 15 min. Two minutes after the third cocaine dose, each dog was randomly assigned to receive 2 mEq/kg i.v. sodium bicarbonate (1 mEq/ml) or 2 mEq/kg i.v. sodium chloride (1 mEq/ml). ECG, electrophysiologic, and hemodynamic data were recorded at baseline, after each cocaine injection, and after administration of sodium bicarbonate or sodium chloride. In both groups of animals, the first cocaine injection significantly (p < 0.05) prolonged the PR, QTc, AH, and HV intervals, and QRS duration compared with baseline. All intervals continued to lengthen in a dose-dependent manner after the second and third cocaine doses. Sodium bicarbonate significantly (p < 0.05) reduced cocaine-induced prolongation of PR [(147 +/- 5-130 +/- 5 ms), AH (81 +/- 6 - 72 +/- 6 ms), and HV intervals (55 +/- 2 - 39 +/- 1 ms). and QRS duration (96 +/- 6 - 66 +/- 4 ms), peak effect after third cocaine dose versus after sodium bicarbonate, respectively]. Sodium chloride had no effect on reversing cocaine-induced effects on the ECG. Cocaine produces dose-dependent slowing of cardiac conduction that is effectively reversed by sodium bicarbonate. The lack of efficacy of sodium chloride suggests that the increase in arterial pH associated with sodium bicarbonate is responsible for reversal of the effects of cocaine on the ECG. Therefore sodium bicarbonate may be clinically useful in the treatment of cocaine-induced cardiac arrhythmias, primarily as a result of its effects on arterial pH.

Animals↗

The effect of sodium bicarbonate and sodium citrate ingestion on anaerobic power during intermittent exercise.

The effect of sodium bicarbonate and sodium citrate ingestion on cycling performance in three 30 s Wingate Anaerobic Tests separated by 6 min recovery periods has been studied using 6 male subjects. Subjects ingested either sodium bicarbonate (B), sodium bicarbonate plus sodium citrate (BC), sodium citrate (C) or sodium chloride (P) 2.5 h prior to exercise in a dose of 0.3 g kg-1 body weight. Pre-exercise blood pH was 7.44 +/- 0.06, 7.42 +/- 0.05, 7.41 +/- 0.05 and 7.38 +/- 0.04 in the C, BC, B and P conditions respectively. Mean and peak power output were significantly reduced by successive Wingate tests but not significantly affected by the treatments. Performance in the second and third tests was highest following C, BC and B ingestion. The total work done in the 3 tests was 103%, 102% and 101% of that achieved in the P condition after C, BC and B ingestion respectively. The increased alkali reserve recorded subsequent to bicarbonate and citrate treatment reduced mean post-exercise acidosis, although pH was significantly higher only in the C condition (p less than 0.05) compared to P after each exercise bout. No significant differences in plasma lactate concentration were recorded at any time. Citrate ingestion appears to be most effective in elevating blood pH and [HCO3-], and in enhancing performance in short-term intermittent exercise. This study demonstrates that alkali ingestion results in significant shifts in the acid-base balance of the blood and has a small, but non-significant, effect on anaerobic power and capacity as measured in a series of 3 Wingate Anaerobic Tests.

Acid-Base Equilibrium↗

Effects of sodium bicarbonate or sodium sesquicarbonate on lactating Holsteins fed a high grain diet.

Fifteen Holstein cows, 35 to 70 d postpartum, were assigned to five 3 x 3 Latin squares. Treatments were: control (60% concentrate, 40% corn silage, DM basis) or control supplemented with either .71% sodium bicarbonate or .65% sodium sesquicarbonate, DM basis. Orthogonal contrasts compared the effect of both buffered diets versus the control diet, and the effect of sodium bicarbonate supplementation vs. sodium sesquicarbonate supplementation. There were no differences among treatments for milk yield (34.9 kg/d), milk fat yield (.99 kg/d), 3.5% FCM (31.1 kg/d), or milk protein concentration (3.15%). There were no treatment effects on total chewing time. Milk fat concentration tended to be greater for cows fed sodium bicarbonate (2.92%) and sodium sesquicarbonate (2.89%) relative to control (2.82%). Relative to control, sodium bicarbonate and sodium sesquicarbonate supplementation increased DM intake (22.0 and 22.7 vs. 21.4 kg/d), digestible DM intake (16.7 and 16.2 vs. 14.8 kg/d), digestible organic matter intake (16.0 and 15.5 vs. 14.3 kg/d); and apparent digestibility of DM (77.3 and 74.8 vs. 73.3%) and NDF (62.6 and 56.5 vs. 54.7%). Relative to sesquicarbonate, bicarbonate supplementation increased apparent digestibilities of CP (82.3 vs. 78.8%) and NDF, and decreased milk protein yield (1.06 vs. 1.11 kg/d). Sesquicarbonate was as effective as bicarbonate in alleviating milk fat depression and increasing intake of digestible organic matter.

Animals↗

Comparative solubilisation of potassium carbonate, sodium bicarbonate and sodium carbonate in hot dimethylformamide: application of cylindrical particle surface-controlled dissolution theory.

A surface-controlled dissolution of cylindrical solid particles model is applied to potassium carbonate, sodium bicarbonate and sodium carbonate in dimethylformamide at elevated temperatures. Previously published data for the dissolution of potassium carbonate is interpreted assuming a cylindrical rather than a spherical shape of the particles, the former representing a closer approximation to the true shape of the particles as revealed by scanning electron microscopy. The dissolution kinetics of sodium carbonate and sodium bicarbonate in dimethylformamide at 100 degrees C were investigated via monitoring of the deprotonation of 2-cyanophenol with dissolved solid to form the 2-cyanophenolate anion that was detected with UV-visible spectroscopy. From fitting of experimental results to theory, the dissolution rate constant, k, for the dissolutions of potassium carbonate, sodium bicarbonate and sodium carbonate in dimethylformamide at 100 degrees C were found to have the values of (1.0 +/- 0.1) x 10(-7) mol cm(-2) s(-1), (5.5 +/- 0.3) x 10(-9) mol cm(-2) s(-1) and (9.7 +/- 0.8) x 10(-9) mol cm(-2) s(-1), respectively.

Adsorption↗

Effects of sodium bicarbonate and sodium chloride on the elimination of etorphine in equine urine.

The combination of large doses of sodium bicarbonate and the potent narcotic, etorphine, has reportedly been given to racehorses in attempts to improve their performance and also to "mask" the presence of etorphine in urine samples. The increased urinary output and pH associated with sodium bicarbonate (approximately 500 g) administration may reduce the urinary concentration of etorphine, making it more difficult to detect. Our experiment was designed to examine the effects of this combination. Six Thoroughbred horses were used in a latin-square design with three horse pairs and three treatments consisting of the following: etorphine (20 micrograms), etorphine (20 micrograms) plus sodium bicarbonate (1.0 g/kg), and etorphine (20 micrograms) plus sodium chloride (0.7 g/kg). Sodium chloride was used to distinguish between the urinary alkalinizing effects of sodium bicarbonate and the diuretic effects associated with the large electrolyte load. Venous blood and urine samples were collected prior to and for 24 h post-treatment. Sodium bicarbonate produced a significant metabolic alkalosis and an increase in urine pH. Both sodium bicarbonate and sodium chloride produced a profound diuresis. After sodium bicarbonate and sodium chloride treatments, the urinary concentration of etorphine, measured by radioimmunoassay (RIA), was reduced and in some cases could not be detected. Extraction of the urine samples, prior to RIA analysis, increased the sensitivity of the assay and in most cases gave a positive result. We conclude that the coadministration of etorphine and sodium bicarbonate or sodium chloride can make the detection of etorphine more difficult because of the dilutional effects associated with the administration of a large electrolyte load.

Animals↗

The effects of sodium bicarbonate and sodium citrate on 600 m running time of trained females.

The effects of sodium bicarbonate and sodium citrate ingestion on 600 m running performance were assessed in 11 female track athletes and four trained female non-athletes. The subjects ingested either sodium bicarbonate (NaHCO3), sodium citrate or placebo approximately 2.5 hrs prior to the test runs in doses of 0.3 g/kg body weight in a double blind cross over design. Prior to and after exercise NaHCO3, H+, and lactate (HLa) concentrations were measured and running times were recorded. Pre- and post-experiment baseline testings were also performed. Data analysis was conducted using a Manova Repeated Measures design and dependent "t"-test. Although differences in running times were found 121.5 s, 119.9 s, 120.4 s in bicarbonate, citrate and placebo treatments respectively, they were not significant. The pH and concentrations of NaHCO3 were significantly elevated prior to and after the exercise when alkalinizing agents were ingested (p < 0.001). In bicarbonate treatment, prior to exercise pH was 7.40 and [NaHCO3] was 28.4 mEq/l, and after the exercise pH was 7.14 and [NaHCO3] was 17.9 mEq/l. In citrate treatment, prior to exercise pH was 7.40 and [NaHCO3] was 27.1 mEq/l, and after the exercise pH was 7.13 and [NaHCO3] was 16.6 mEq/l. There were no significant differences among the pre-exercise (2.3 mmol/l, 2.1 mmol/l, 2.2 mmol/l in bicarbonate, citrate and placebo treatments respectively) and after-exercise (11.8 mmol/l, 11.9 mmol/l, 11.0 mmol/l bicarbonate, citrate and placebo, respectively) HLa concentrations. This study demonstrated that, although alkali ingestion resulted in significant shifts in the blood acid-base balance, it failed to affect the 600 m running performance.

Acid-Base Imbalance↗

Effect of sodium bicarbonate and sodium starch glycolate on the in vivo disintegration of hard gelatin capsules--a radiological study in the dog.

The release of drugs from hard gelatin capsules is often limited by the disintegration rate of the capsule. We set out to determine whether it is possible to hasten the in vivo disintegration of hard gelatin capsules by adding disintegrants (sodium bicarbonate or sodium starch glycolate) to the formulation. This radiological study was carried out in six beagle dogs. We conclude that if rapid disintegration is desired for a hard gelatin capsule formulation, water-soluble diluents should primarily be selected. Sparingly water-soluble, gelforming diluents cause slow in vivo disintegration. Using swellable disintegrants such as sodium starch glycolate does not accelerate disintegration and may even retard it. With sodium bicarbonate it is possible to shorten the disintegration time of capsules containing water-insoluble ingredients, but not to the extent possible with water-soluble diluents.

Animals↗

Comparison of the effects of sodium bicarbonate versus sodium citrate on renal acid excretion.

Citrate is used commonly as an alkalinizing agent and in the management of nephrolithiasis, but its quantitative effect on acid-base homeostasis, as judged by changes in renal net acid excretion, has not been delineated. We therefore administered 61 mEq of sodium citrate/day for 4 days to 10 normal volunteers and compared the results to those obtained in 10 normal subjects (4 of whom also participated in the citrate protocol) given 60 mEq/day for 4 days of sodium bicarbonate, the prototypical alkalinizing agent. We found that the sodium citrate group experienced an average reduction in net acid excretion (45.5 +/- 7.2 mEq/day) that was very similar to that (42.0 +/- 7.2 mEq/day) induced by the same amount of sodium bicarbonate. In both groups, the reduction in net acid excretion was equivalent to approximately 70% of the alkali administered. The latter appeared to relate to an average negative hydrogen ion balance of approximately 15 mEq/day, since there was an increase in blood [HCO3] in each group of about 2.5 mEq/l. We conclude that the findings demonstrate that the short-term effects of sodium citrate on acid-base homeostasis in normal subjects are indistinguishable from those of sodium bicarbonate.

Acids↗

Effect of sodium bicarbonate and sodium bentonite on digestion, solid and liquid flow, and ruminal fermentation characteristics of forage sorghum silage-based diets fed to steers.

Six ruminally cannulated steers, five Holsteins and one Hereford (250 to 295 kg), were fed 84% forage sorghum silage plus 16% supplement or 50% forage sorghum silage plus concentrate and supplement diets containing either no addition (controls), 1% sodium bicarbonate (NaHCO3) or 2% sodium bentonite in a 2 X 3 factorial arrangement of treatments in a 6 X 6 Latin-square experiment with 3-wk periods. Sodium bicarbonate increased dry matter (DM) intake when concentrate was included, but neither compound affected intake of the 84% silage diet. Bentonite lowered DM, neutral detergent fiber (NDF), and acid detergent fiber (ADF) digestibilities, but NDF disappearance from nylon bags was unchanged. Ruminal pH, osmolality and L(+) and D(-) lactate were not affected by treatment. Both NaHCO3 and bentonite tended to lower ruminal NH3-N concentrations. Bentonite lowered the molar proportion of isobutyrate in ruminal fluid relative to controls, but proportions of other volatile fatty acids (VFA) and total VFA concentrations were unchanged. Neither NaHCO3 nor bentonite affected ruminal liquid or solid volumes, dilution rate constants or ruminal outflow rates. Markers overestimated volumes, but correction with measured volumes did not change interpretation of treatment effects. It was concluded that control diets had sufficiently high baseline values of pH, dilution rate and acetate proportion to preclude changes induced by either compound, especially at 1 or 2% of DM intake. An effect on palatibility through neutralization of silage acids may have been responsible for the intake response to NaHCO3.

Animal Feed↗

Sodium bicarbonate and sodium citrate: ergogenic aids?

Numerous studies have used exogenous administration of sodium bicarbonate (NaHCO(3)) and sodium citrate (Na-citrate) in an attempt to enhance human performance. After ingestion of NaHCO(3) and Na-citrate, two observations have been made: (a) There was great individual variability in the ergogenic benefit reached, which can be attributed to the level of physical conditioning of the subjects and to their tolerance of the buffer substance; and (b) the subjects who had ingested NaHCO(3) and Na-citrate show higher levels of pH, bicarbonate, and lactate ions concentrations in their exercising blood than do the subjects who had ingested the placebo. A majority of the studies have suggested that the ingestion of both substances provides an ergogenic effect due to the establishment and maintenance of an elevated pH level during exercise. However, the exact mechanism by which the ergogenic effects occur has not been demonstrated conclusively. Sodium bicarbonate and Na-citrate seem to be effective in activities with a sufficient duration to generate a difference in the hydrogen ion gradient, characterized by a very high intensity and involving large muscular groups. However, in activities of equally high intensity, but with longer duration, the results obtained have been conflicting and inconclusive.

Citrates↗

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 mm Hg) 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.

3-Hydroxybutyric Acid↗