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Bicarbonate therapy and intracellular acidosis.
Goldsmith, D J; Forni, L G; Hilton, P J.
Afiliação
  • Goldsmith DJ; Renal Laboratory, St Thomas' Hospital, London, U.K.
Clin Sci (Lond) ; 93(6): 593-8, 1997 Dec.
Article em En | MEDLINE | ID: mdl-9497798
ABSTRACT
1. The correction of metabolic acidosis with sodium bicarbonate remains controversial. Experiments in vitro have suggested possible deleterious effects after alkalinization of the extracellular fluid. Disequilibrium of carbon dioxide and bicarbonate across cell membranes after alkali administration, leading to the phenomenon of 'paradoxical' intracellular acidosis, has been held responsible for some of these adverse effects. 2. Changes in intracellular pH in suspensions of leucocytes from healthy volunteers were monitored using a fluorescent intracellular dye. The effect in vitro of increasing extracellular pH with sodium bicarbonate was studied at different sodium bicarbonate concentrations. Lactic acid and propionic acid were added to the extracellular buffer to mimic conditions of metabolic acidosis. 3. The addition of a large bolus of sodium bicarbonate caused intracellular acidification as has been observed previously. The extent of the intracellular acidosis was dependent on several factors, being most evident at higher starting intracellular pH. When sodium bicarbonate was added as a series of small boluses the reduction in intracellular pH was small. Under conditions of initial acidosis this was rapidly followed by intracellular alkalinization. 4. Although intracellular acidification occurs after addition of sodium bicarbonate to a suspension of human leucocytes in vitro, the effect is minimal when the conditions approximate those seen in clinical practice. We suggest that the observed small and transient lowering of intracellular pH is insufficient grounds in itself to abandon the use of sodium bicarbonate in human acidosis.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Contexto em Saúde: 6_ODS3_enfermedades_notrasmisibles Problema de saúde: 6_endocrine_disorders / 6_other_blood_disorders Assunto principal: Acidose Láctica / Bicarbonato de Sódio / Leucócitos Limite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Sci (Lond) Ano de publicação: 1997 Tipo de documento: Article País de afiliação: Reino Unido
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Coleções: 01-internacional Base de dados: MEDLINE Contexto em Saúde: 6_ODS3_enfermedades_notrasmisibles Problema de saúde: 6_endocrine_disorders / 6_other_blood_disorders Assunto principal: Acidose Láctica / Bicarbonato de Sódio / Leucócitos Limite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Sci (Lond) Ano de publicação: 1997 Tipo de documento: Article País de afiliação: Reino Unido
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