Hippokratia 2005; 9(2):54-59
G Efstratiadis, E Damvopoulou, G Tsiaousis
Nephrology Dpt, Hippokratio General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
Cardiac arrest and the subsequent acidosis consist a major clinical challenge in the Intensive Care Unit, and anywhere Medicine is practiced. The effort to optimize its treatment led to the reconsideration of the axiom of administering bicarbonate, through experimental (in animal models and in humans) and clinical research, which contributed to a better understanding of the acidosis that accompanies cardiac arrest. The sort of acid-base disturbance that characterizes cardiac arrest is described, as well as its exact biochemical basis and the methods used to monitor its course. Finally, the arguments in favour of and against the use of bicarbonate are discussed, and the guidelines concerning this issue presented.
Keywords: cardiac arrest, metabolic acidisis, lactic acidosis, bicarbonate treatment