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1.
J Int Soc Sports Nutr ; 17(1): 22, 2020 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-32307012

RESUMO

BACKGROUND: The present study investigated the effects of chronic sodium bicarbonate (NaHCO3) ingestion on a single bout of high-intensity exercise and on acid-base balance during 7-day high-altitude exposure. METHODS: Ten recreationally active subjects participated in a pre-test at sea level and a 7-day hiking tour in the Swiss Alps up to 4554 m above sea level. Subjects received either a daily dose of 0.3 g/kg NaHCO3 solution (n = 5) or water as a placebo (n = 5) for 7 days. Anaerobic high-intensity exercise performance was assessed using the portable tethered sprint running (PTSR) test under normoxic and hypoxic conditions (3585 m). PTSR tests assessed overall peak force, mean force, and fatigue index. Blood lactate levels and blood gas parameters were assessed pre- and post-PTSR. Urinary pH and blood gas parameters were further analyzed daily at rest in early morning samples under normoxic and hypoxic conditions. RESULTS: There were no significant differences between the bicarbonate and control group in any of the PTSR-related parameters. However, urinary pH (p = 0.003, ηp2 = 0.458), early morning blood bicarbonate concentration (p < 0.001, ηp2 = 0.457) and base excess (p = 0.002, ηp2 = 0.436) were significantly higher in the bicarbonate group compared with the control group under hypoxic conditions. CONCLUSIONS: These results indicate that oral NaHCO3 ingestion does not ameliorate the hypoxia-induced impairment in anaerobic, high-intensity exercise performance, represented by PTSR-related test parameters, under hypobaric, hypoxic conditions, but the maximal performance measurements may have been negatively affected by other factors, such as poor implementation of PTSR test instructions, pre-acclimatization, the time course of hypoxia-induced renal [HCO3-] compensation, changes in the concentrations of intra- and extracellular ions others than [H+] and [HCO3-], or gastrointestinal disturbances caused by NaHCO3 ingestion. However, chronic NaHCO3 ingestion improves blood bicarbonate concentration and base excess at altitude, which partially represent the blood buffering capacity.


Assuntos
Equilíbrio Ácido-Base/efeitos dos fármacos , Altitude , Limiar Anaeróbio/efeitos dos fármacos , Montanhismo , Bicarbonato de Sódio/administração & dosagem , Adulto , Feminino , Humanos , Masculino , Fenômenos Fisiológicos da Nutrição Esportiva
2.
Sci Rep ; 10(1): 1878, 2020 02 05.
Artigo em Inglês | MEDLINE | ID: mdl-32024852

RESUMO

The aim of this study was the assessment of progressive low-dose sodium bicarbonate (NaHCO3) supplementation on the anaerobic indices in two bouts of Wingate tests (WT) separated by wrestling-specific performance test and assessing the gender differences in response. Fifty-one (18 F) wrestlers completed a randomized trial of either a NaHCO3 (up to 100 mg·kg-1) or a placebo for 10 days. Before and after treatment, athletes completed an exercise protocol that comprised, in sequence, the first WT1, dummy throw test (DT), and second WT2. The number of completed throws increased significantly in males from 19.3 ± 2.6 NaHCO3pre to 21.7 ± 2.9 NaHCO3post. ΔWT2-WT1 improved particularly in the midsection of 30-s WT on NaHCO3. However, no significant differences were found in peak power (PP), power drop (PD) and average power (AP) (analyzed separately for each WT), and ΔWT2-WT1 in PP and PD. Interaction with gender was significant for AP, PP and PD, every second of WT1 and WT2, as well as DT test. In conclusion, our study suggests that the response to NaHCO3 may be gender-specific and progressive low-dose NaHCO3 supplementation allows the advantageous strengthening of wrestling-specific performance in males. It can also lead to maintenance of high anaerobic power mainly in the midsection of the 30-s Wingate test.


Assuntos
Limiar Anaeróbio/efeitos dos fármacos , Desempenho Atlético/fisiologia , Suplementos Nutricionais , Bicarbonato de Sódio/administração & dosagem , Luta Romana/fisiologia , Adolescente , Limiar Anaeróbio/fisiologia , Atletas , Teste de Esforço/efeitos dos fármacos , Feminino , Humanos , Masculino , Fatores Sexuais , Adulto Jovem
4.
JAMA Intern Med ; 180(4): 533-541, 2020 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-32065601

RESUMO

Importance: Prevention of postcontrast acute kidney injury in patients with stage 3 chronic kidney disease (CKD) by means of prehydration has been standard care for years. However, evidence for the need for prehydration in this group is limited. Objective: To assess the renal safety of omitting prophylactic prehydration prior to iodine-based contrast media administration in patients with stage 3 CKD. Design, Setting, and Participants: The Kompas trial was a multicenter, noninferiority, randomized clinical trial conducted at 6 hospitals in the Netherlands in which 523 patients with stage 3 CKD were randomized in a 1:1 ratio to receive no prehydration or prehydration with 250 mL of 1.4% sodium bicarbonate administered in a 1-hour infusion before undergoing elective contrast-enhanced computed tomography from April 2013 through September 2016. Final follow-up was completed in September 2017. Data were analyzed from January 2018 to June 2019. Interventions: In total, 262 patients were allocated to the no prehydration group and 261 were allocated to receive prehydration. Analysis on the primary end point was available in 505 patients (96.6%). Main Outcomes and Measures: The primary end point was the mean relative increase in serum creatinine level 2 to 5 days after contrast administration compared with baseline (noninferiority margin of less than 10% increase in serum creatinine level). Secondary outcomes included the incidence of postcontrast acute kidney injury 2 to 5 days after contrast administration, mean relative increase in creatinine level 7 to 14 days after contrast administration, incidences of acute heart failure and renal failure requiring dialysis, and health care costs. Results: Of 554 patients randomized, 523 were included in the intention-to-treat analysis. The median (interquartile range) age was 74 (67-79) years; 336 (64.2%) were men and 187 (35.8%) were women. The mean (SD) relative increase in creatinine level 2 to 5 days after contrast administration compared with baseline was 3.0% (10.5) in the no prehydration group vs 3.5% (10.3) in the prehydration group (mean difference, 0.5; 95% CI, -1.3 to 2.3; P < .001 for noninferiority). Postcontrast acute kidney injury occurred in 11 patients (2.1%), including 7 of 262 (2.7%) in the no prehydration group and 4 of 261 (1.5%) in the prehydration group, which resulted in a relative risk of 1.7 (95% CI, 0.5-5.9; P = .36). None of the patients required dialysis or developed acute heart failure. Subgroup analyses showed no evidence of statistical interactions between treatment arms and predefined subgroups. Mean hydration costs were €119 (US $143.94) per patient in the prehydration group compared with €0 (US $0) in the no prehydration group (P < .001). Other health care costs were similar. Conclusions and Relevance: Among patients with stage 3 CKD undergoing contrast-enhanced computed tomography, withholding prehydration did not compromise patient safety. The findings of this study support the option of not giving prehydration as a safe and cost-efficient measure. Trial Registration: Netherlands Trial Register Identifier: NTR3764.


Assuntos
Lesão Renal Aguda/prevenção & controle , Meios de Contraste/efeitos adversos , Soluções para Reidratação/uso terapêutico , Insuficiência Renal Crônica/complicações , Bicarbonato de Sódio/administração & dosagem , Tomografia Computadorizada por Raios X , Lesão Renal Aguda/induzido quimicamente , Idoso , Creatinina/sangue , Feminino , Humanos , Masculino , Países Baixos
5.
Zhonghua Nei Ke Za Zhi ; 59(2): 165-168, 2020 Feb 01.
Artigo em Chinês | MEDLINE | ID: mdl-32074694

RESUMO

A 47-year-old female patient presented nausea and vomiting for half a year and elevated serum creatinine for 3 days. Proximal renal tubular acidosis (RTA) complicated with anemiawas confirmed after admission. Secondary factors, such as autoimmune disease, drugs, poison, monoclonal gammopathy, were excluded. Renal biopsy revealed acute interstitial nephritis. The patient was administrated with daily prednisone 50 mg, sodium bicarbonate 4 g, 3 times per day, erythropoietin 3 000 U, 2 times per week, combined with potassium, calcium, and calcitriol tablets. Serum creatinine reduced to 90 µmol/L. However nausea and vomiting deteriorated with lactic acidosis. Bone marrow biopsy indicated the diagnosis of non-Hodgkin lymphoma, therefore the patient was treated with chemotherapy. Although metabolic acidosis improved gradually after chemotherapy, severe pneumocystis carinii pneumonia developed two weeks later. The patient refused further treatment and was discharged.


Assuntos
Acidose Láctica/complicações , Acidose Tubular Renal/patologia , Anemia/complicações , Linfoma não Hodgkin/patologia , Pneumonia por Pneumocystis/diagnóstico , Insuficiência Renal/complicações , Acidose Láctica/sangue , Antineoplásicos/administração & dosagem , Biópsia , Creatinina/sangue , Eritropoetina/administração & dosagem , Feminino , Humanos , Linfoma não Hodgkin/tratamento farmacológico , Pessoa de Meia-Idade , Náusea , Pneumonia por Pneumocystis/complicações , Prednisona/administração & dosagem , Bicarbonato de Sódio/administração & dosagem , Recusa do Paciente ao Tratamento , Vômito
6.
Anticancer Res ; 40(2): 873-880, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32014931

RESUMO

BACKGROUND/AIM: The acidic tumor microenvironment is associated both with the progression and drug resistance of cancer. We aimed to investigate the effects of alkalization therapy performed concurrently with chemotherapy on the survival of advanced pancreatic cancer patients (study registration: UMIN 000035659). PATIENTS AND METHODS: Twenty-eight patients with metastatic or recurrent pancreatic cancer were assessed in this study. Alkalization therapy consisted of an alkaline diet with supplementary oral sodium bicarbonate (3.0-5.0 g/day). RESULTS: The mean urine pH was significantly higher after the alkalization therapy (6.85±0.74 vs. 6.39±0.92; p<0.05). The median overall survival from the start of alkalization therapy of the patients with high urine pH (>7.0) was significantly longer than those with low urine pH (≤ 7.0) (16.1 vs. 4.7 months; p<0.05). CONCLUSION: An alkalization therapy may be associated with better outcomes in advanced pancreatic cancer patients treated with chemotherapy.


Assuntos
Recidiva Local de Neoplasia/dietoterapia , Recidiva Local de Neoplasia/tratamento farmacológico , Neoplasias Pancreáticas/dietoterapia , Neoplasias Pancreáticas/tratamento farmacológico , Bicarbonato de Sódio/administração & dosagem , Idoso , Idoso de 80 Anos ou mais , Suplementos Nutricionais , Feminino , Humanos , Concentração de Íons de Hidrogênio , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/urina , Neoplasias Pancreáticas/patologia , Neoplasias Pancreáticas/urina , Estudos Retrospectivos
7.
Crit Care Resusc ; 22(1): 80-82, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32102646

RESUMO

BACKGROUND: Due to the lack of double-blind randomised controlled trials, the true effect of intravenous sodium bicarbonate therapy in ICU patients with metabolic acidosis remains unclear. METHODS: We diluted 100 mL 8.4% sodium bicarbonate in 150 mL 5% dextrose (D5W) within a 250 mL polyolefin bag after removing 100 mL. We asked ICU clinicians to inspect a 250 mL bag containing sodium bicarbonate or a 250 mL bag where 100 mL of D5W had been removed and then returned. The bags were attached to intravenous giving sets. We asked participants to identify the contents of the bags. RESULTS: Among 60 participants (39 nursing staff [65%], 20 medical staff [33.3%] and one pharmacist), 36 (60%) answered correctly. The Cohen κ for agreement between test bag content and participants' answers was 0.20 (95% CI, -0.05 to 0.45; P = 0.12), implying the answers were correct by chance. In the group of 28 participants who indicated they used a clue to help them decide their answer, 15 (53.6%) answered correctly, whereas in the remainder (n = 32), 21 (65.6%) answered correctly (P = 0.49). CONCLUSION: When 100 mL of 8.4% sodium bicarbonate were diluted in 150 mL of D5W within a 250 mL polyolefin bag, clinicians were unable to correctly identify the contents of the bags. Our findings imply that sodium bicarbonate therapy can be successfully blinded.


Assuntos
Acidose/tratamento farmacológico , Glucose/uso terapêutico , Bicarbonato de Sódio/uso terapêutico , Administração Intravenosa , Método Duplo-Cego , Eletrólitos , Glucose/administração & dosagem , Humanos , Injeções Intravenosas , Sódio/sangue , Bicarbonato de Sódio/administração & dosagem , Resultado do Tratamento
8.
Int J Sports Physiol Perform ; 15(5): 741-747, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-31952047

RESUMO

BACKGROUND: Gross efficiency (GE) declines during high-intensity exercise. Increasing extracellular buffer capacity might diminish the decline in GE and thereby improve performance. PURPOSE: To examine if sodium bicarbonate (NaHCO3) supplementation diminishes the decline in GE during a 2000-m cycling time trial. METHODS: Sixteen male cyclists and 16 female cyclists completed 4 testing sessions including a maximal incremental test, a familiarization trial, and two 2000-m GE tests. The 2000-m GE tests were performed after ingestion of either NaHCO3 supplements (0.3 g/kg body mass) or placebo supplements (amylum solani, magnesium stearate, and sunflower oil capsules). The GE tests were conducted using a double-blind, randomized, crossover design. Power output, gas exchange, and time to complete the 2000-m time trials were recorded. Capillary blood samples were analyzed for blood bicarbonate, pH, and lactate concentration. Data were analyzed using magnitude-based inference. RESULTS: The decrement in GE found after the 2000-m time trial was possibly smaller in the male and female groups after NaHCO3 than with placebo ingestion, with the effect in both groups combined being unclear. The effect on performance was likely trivial for males (placebo 164.2 [5.0] s, NaHCO3 164.3 [5.0] s; Δ0.1; ±0.6%), unclear for females (placebo 178.6 [4.8] s, NaHCO3 178.0 [4.3] s; Δ-0.3; ±0.5%), and very likely trivial when effects were combined. Blood bicarbonate, pH, and lactate concentration were substantially elevated from rest to pretest after NaHCO3 ingestion. CONCLUSIONS: NaHCO3 supplementation results in an unclear effect on the decrease in GE during high-intensity exercise and in a very likely trivial effect on performance.


Assuntos
Ciclismo/fisiologia , Suplementos Nutricionais , Resistência Física/fisiologia , Bicarbonato de Sódio/administração & dosagem , Adulto , Método Duplo-Cego , Feminino , Humanos , Concentração de Íons de Hidrogênio , Ácido Láctico/sangue , Masculino , Troca Gasosa Pulmonar , Bicarbonato de Sódio/sangue
9.
Am J Kidney Dis ; 75(2): 225-234, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31699517

RESUMO

RATIONALE & OBJECTIVE: Metabolic acidosis associated with chronic kidney disease (CKD) may contribute to muscle dysfunction and bone disease. We aimed to test whether treatment with sodium bicarbonate improves muscle and bone outcomes. STUDY DESIGN: Multicenter, randomized, placebo-controlled, clinical trial. SETTING & PARTICIPANTS: 149 patients with CKD stages 3 and 4 between July 2011 and April 2016 at 3 centers in Cleveland, OH, and the Bronx, NY. INTERVENTION: Sodium bicarbonate (0.4 mEq per kg of ideal body weight per day) (n=74) or identical-appearing placebo (n=75). OUTCOMES: Dual primary outcomes were muscle function assessed using sit-to-stand test and bone mineral density. Muscle biopsies were performed at baseline and 2 months. Participants were seen at baseline and 2, 6, 12, and 24 months. RESULTS: Mean baseline serum bicarbonate level was 24.0±2.2 (SD) mEq/L and mean baseline estimated glomerular filtration rate was 36.3±11.2mL/min/1.73m2. Baseline characteristics did not differ between groups. Mean serum bicarbonate levels in the intervention arm during follow-up were 26.4±2.2, 25.5±2.3, 25.6±2.6, and 24.4±2.8 mEq/L (at 2, 6, 12, and 24 months). These were significantly higher than in the placebo group (P<0.001). Compared to the placebo group, participants randomly assigned to sodium bicarbonate treatment had no significant differences in sit-to-stand time (5 repetitions: P=0.1; and 10 repetitions P=0.07) or bone mineral density (P=0.3). Sodium bicarbonate treatment caused a decrease in serum potassium levels that was of borderline statistical significance (P=0.05). There were no significant differences in estimated glomerular filtration rates, blood pressure, weight, serious adverse events, or levels of muscle gene expression between the randomly assigned groups. LIMITATIONS: Initial mean serum bicarbonate level was in the normal range. CONCLUSIONS: Sodium bicarbonate therapy in patients with CKD stages 3 and 4 significantly increases serum bicarbonate and decreases potassium levels. No differences were found in muscle function or bone mineral density between the randomly assigned groups. Larger trials are required to evaluate effects on kidney function. FUNDING: National Institutes of Health grant. TRIAL REGISTRATION: Registered at ClinicalTrials.gov with study number NCT01452412.


Assuntos
Taxa de Filtração Glomerular/fisiologia , Insuficiência Renal Crônica/tratamento farmacológico , Bicarbonato de Sódio/administração & dosagem , Bicarbonatos/sangue , Biomarcadores/sangue , Progressão da Doença , Relação Dose-Resposta a Droga , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Potássio/sangue , Insuficiência Renal Crônica/sangue , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/fisiopatologia , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento
10.
Am J Kidney Dis ; 75(2): 187-194, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31547939

RESUMO

RATIONALE & OBJECTIVE: The PRESERVE trial used a 2 × 2 factorial design to compare intravenous saline solution with intravenous sodium bicarbonate solution and oral N-acetylcysteine with placebo for the prevention of 90-day major adverse kidney events and death (MAKE-D) and contrast-associated acute kidney injury (CA-AKI) among patients with chronic kidney disease undergoing angiography. In this ancillary study, we evaluated the predictive capacities of preangiography injury and repair proteins in urine and plasma for MAKE-D, CA-AKI, and their impact on trial design. STUDY DESIGN: Longitudinal analysis. SETTING & PARTICIPANTS: A subset of participants from the PRESERVE trial. EXPOSURES: Injury (KIM-1, NGAL, and IL-18) and repair (MCP-1, UMOD, and YKL-40) proteins in urine and plasma 1 to 2 hours preangiography. OUTCOMES: MAKE-D and CA-AKI. ANALYTICAL APPROACH: We analyzed the associations of preangiography biomarkers with MAKE-D and with CA-AKI. We evaluated whether the biomarker levels could enrich the MAKE-D event rate and improve future clinical trial efficiency through an online biomarker prognostic enrichment tool available at prognosticenrichment.com. RESULTS: We measured plasma biomarkers in 916 participants and urine biomarkers in 797 participants. After adjusting for urinary albumin-creatinine ratio and baseline estimated glomerular filtration rate, preangiography levels of 4 plasma (KIM-1, NGAL, UMOD, and YKL-40) and 3 urine (NGAL, IL-18, and YKL-40) biomarkers were associated with MAKE-D. Only plasma KIM-1 level was significantly associated with CA-AKI after adjustment. Biomarker levels provided modest discriminatory capacity for MAKE-D. Screening patients using the 50th percentile of preangiography plasma KIM-1 or YKL-40 levels would have reduced the required sample size by 30% (∼2,000 participants). LIMITATIONS: Evaluation of prognostic enrichment does not account for changing trial costs, time needed to screen patients, or loss to follow-up. Most participants were male, limiting the generalizability of our findings. CONCLUSIONS: Preangiography levels of injury and repair biomarkers modestly predict the development of MAKE-D and can be used to improve the efficiency of future CA-AKI trials.


Assuntos
Acetilcisteína/administração & dosagem , Lesão Renal Aguda/metabolismo , Proteínas da Fase Aguda/metabolismo , Angiografia/efeitos adversos , Meios de Contraste/efeitos adversos , Citocinas/metabolismo , Bicarbonato de Sódio/administração & dosagem , Lesão Renal Aguda/induzido quimicamente , Lesão Renal Aguda/tratamento farmacológico , Administração Oral , Idoso , Biomarcadores/sangue , Biomarcadores/urina , Feminino , Seguimentos , Depuradores de Radicais Livres/administração & dosagem , Taxa de Filtração Glomerular , Humanos , Infusões Intravenosas , Testes de Função Renal , Masculino , Prognóstico
11.
J Am Soc Nephrol ; 31(1): 161-174, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31848294

RESUMO

BACKGROUND: Oral sodium bicarbonate (NaHCO3) may preserve kidney function in CKD, even if initiated when serum bicarbonate concentration is normal. Adequately powered trials testing this hypothesis have not been conducted, partly because the best dose for testing is unknown. METHODS: This multicenter pilot trial assessed the safety, tolerability, adherence, and pharmacodynamics of two doses of NaHCO3 over 28 weeks in adults with eGFR 20-44 or 45-59 ml/min per 1.73 m2 with urinary albumin/creatinine (ACR) ≥50 mg/g and serum bicarbonate 20-28 meq/L. We randomly assigned 194 participants from ten clinical sites to receive higher-dose (HD-NaHCO3; 0.8 meq/kg of lean body wt per day; n=90) or lower-dose (LD-NaHCO3; 0.5 meq/kg of lean body wt per day; n=52) NaHCO3 or matching placebo (n=52). The dose was adjusted depending on side effects. The prescribed dose at week 28 was the primary outcome; a dose was considered acceptable for a full-scale trial if ≥67% of participants were on full-dose and ≥80% were on ≥25% of the per-protocol dose. RESULTS: Mean±SD baseline eGFR was 36±9 ml/min per 1.73 m2, serum bicarbonate was 24±2 meq/L, and median (IQR) ACR was 181 (25-745) mg/g. Both doses were well tolerated without significant changes in BP, weight, or serum potassium. The proportions of adverse events and hospitalizations were similar across the groups. Consequently, 87% in HD-NaHCO3, 96% in LD-NaHCO3, and 87% in placebo were on full dose at week 28; and 91% in HD-NaHCO3, 98% in LD-NaHCO3, and 92% in placebo were on ≥25% of the per-protocol dose. Mean urinary ammonium excretion was 25% lower and serum bicarbonate concentration was 1.3 meq/L higher in HD-NaHCO3 compared with LD-NaHCO3 at week 28. However, mean ACR increased by 12% in the lower-dose group and 30% in the higher-dose group. CONCLUSIONS: Both NaHCO3 doses were well tolerated over 28 weeks with no significant difference in adverse events or hospitalization compared with placebo. The higher dose lowered urinary ammonium excretion and increased serum bicarbonate more than the lower dose but was associated with a greater increase in ACR. The higher 0.8 meq/kg of lean body wt per day dose of NaHCO3 may be a reasonable choice for future trials.


Assuntos
Adesão à Medicação/estatística & dados numéricos , Insuficiência Renal Crônica/tratamento farmacológico , Bicarbonato de Sódio/administração & dosagem , Bicarbonato de Sódio/farmacocinética , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Bicarbonato de Sódio/efeitos adversos
12.
J Sci Med Sport ; 23(1): 41-47, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31466868

RESUMO

OBJECTIVES: To conduct a systematic review and a meta-analysis of studies exploring the effects of caffeine and/or sodium bicarbonate on performance in the Yo-Yo test. DESIGN: Systematic review and meta-analysis. METHODS: A total of six databases were searched, and random-effects meta-analyses were performed examining the isolated effects of caffeine and sodium bicarbonate on performance in the Yo-Yo test. RESULTS: After reviewing 988 search records, 15 studies were included. For the effects of caffeine on performance in the Yo-Yo test, the meta-analysis indicated a significant favoring of caffeine as compared with the placebo conditions (p=0.022; standardized mean difference [SMD]=0.17; 95% CI: 0.08, 0.32; +7.5%). Subgroup analyses indicated that the effects of caffeine were significant for the level 2 version of the Yo-Yo test, but not level 1. Four out of the five studies that explored the effects of sodium bicarbonate used the level 2 version of the Yo-Yo test. The pooled SMD favored the sodium bicarbonate condition as compared with the placebo/control conditions (p=0.007; SMD: 0.36; 95% CI: 0.10, 0.63; +16.0%). CONCLUSIONS: This review demonstrates that isolated ingestion of caffeine and sodium bicarbonate enhances performance in the Yo-Yo test. Given these ergogenic effects, the intake of caffeine and sodium bicarbonate before the Yo-Yo test needs to be standardized (i.e., either restricted or used in the same way before each testing session). Furthermore, the results suggest that individuals competing in sports involving intermittent exercise may consider supplementing with caffeine or sodium bicarbonate for acute improvements in performance.


Assuntos
Cafeína/administração & dosagem , Substâncias para Melhoria do Desempenho/administração & dosagem , Bicarbonato de Sódio/administração & dosagem , Desempenho Atlético , Exercício Físico , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
13.
J Med Case Rep ; 13(1): 326, 2019 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-31685016

RESUMO

BACKGROUND: Eucalyptus oil poisoning is rare in adults but is not that uncommon in children. The common side effects in children include depression in the level of consciousness, ataxia, seizures, and vomiting. Unlike in children, seizures are unusual in adult patients with eucalyptus oil poisoning. We report the cases of two patients with eucalyptus oil poisoning, both adults who unintentionally took eucalyptus oil and presented to the emergency room of our institution with seizures. CASE PRESENTATION: Two adult Indian men who unintentionally consumed eucalyptus oil presented to the emergency room of our institution with seizures. In both patients, arterial blood gas analysis showed the presence of severe metabolic acidosis. Both the patients were managed in the intensive care unit and received standard supportive care. Metabolic acidosis was corrected with intravenous bicarbonate infusion. They were successfully discharged on the fourth day. CONCLUSIONS: All physicians should be aware of the toxic effects of eucalyptus oil, which is used often in daily life in India. Supportive care in an intensive care unit, including rapid correction of metabolic acidosis and adequate maintenance of hemodynamic parameters, will lead to a rapid recovery. Warning labels should be made mandatory on all products that contain eucalyptus oil.


Assuntos
Acidose/induzido quimicamente , Óleo de Eucalipto/envenenamento , Plantas Medicinais/envenenamento , Convulsões/induzido quimicamente , Bicarbonato de Sódio/administração & dosagem , Lesões Acidentais , Acidose/tratamento farmacológico , Adulto , Humanos , Infusões Intravenosas , Masculino , Convulsões/tratamento farmacológico , Resultado do Tratamento , Adulto Jovem
14.
Drug Des Devel Ther ; 13: 3151-3159, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31564831

RESUMO

Background: Esomeprazole is the most effective treatment for acid-related disorders and is widely used with enteric coating due to rapid degradation in the acidic environment. However, the enteric-coated formulation delays absorption and onset of action. To overcome this limitation, an immediate-release formulation containing esomeprazole 20 mg and sodium bicarbonate 800 mg (IR-ESO) was developed. Purpose: To evaluate the safety, pharmacokinetics (PK), and pharmacodynamics of IR-ESO compared to those of esomeprazole 20 mg (ESO). Methods: A randomized, open-label, multiple-dose, two-treatment, two-sequence crossover study was conducted in 40 healthy male subjects. Subjects received either IR-ESO or ESO for 7 days. After single and multiple dosing, blood samples were collected for PK analysis, and intragastric pH was assessed by 24-hr pH monitoring. Results: Plasma esomeprazole exposure of IR-ESO was similar to that of ESO after single and multiple dosing. Time to peak concentration of IR-ESO (0.50-0.75 hr) was shorter than that of ESO (1.25-1.50 hr). Percentage changes in 24-hr integrated gastric acidity from baseline for IR-ESO were similar to those for ESO. In addition, mean time to maintain gastric pH >4 for 24 hr was similar for both drugs (IR-ESO 55.5-69.9% vs ESO 56.8-70.2%). Evaluation of time to first reach pH 4 after dosing indicated that IR-ESO showed a faster onset than ESO. All subjects found the drug tolerable, and there were no significant differences in adverse events between two drugs. Conclusion: This study showed that IR-ESO produced a rapid, safe and sustained gastric acid suppression (ClinicalTrials.gov: NCT03211143).


Assuntos
Liberação Controlada de Fármacos , Esomeprazol/farmacocinética , Bicarbonato de Sódio/farmacocinética , Administração Oral , Adulto , Estudos Cross-Over , Relação Dose-Resposta a Droga , Composição de Medicamentos , Esomeprazol/administração & dosagem , Esomeprazol/sangue , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Bicarbonato de Sódio/administração & dosagem , Bicarbonato de Sódio/sangue , Adulto Jovem
15.
J Int Soc Sports Nutr ; 16(1): 37, 2019 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-31477133

RESUMO

The timing of macronutrient ingestion in relation to exercise is a purported strategy to augment muscle accretion, muscle and athletic performance, and recovery. To date, the majority of macronutrient nutrient timing research has focused on carbohydrate and protein intake. However, emerging research suggests that the strategic ingestion of various ergogenic aids and micronutrients may also have beneficial effects. Therefore, the purpose of this narrative review is to critically evaluate and summarize the available literature examining the timing of ergogenic aids (caffeine, creatine, nitrates, sodium bicarbonate, beta-alanine) and micronutrients (iron, calcium) on muscle adaptations and exercise performance. In summary, preliminary data is available to indicate the timing of caffeine, nitrates, and creatine monohydrate may impact outcomes such as exercise performance, strength gains and other exercise training adaptations. Furthermore, data is available to suggest that timing the administration of beta-alanine and sodium bicarbonate may help to minimize known untoward adverse events while maintaining potential ergogenic outcomes. Finally, limited data indicates that timed ingestion of calcium and iron may help with the uptake and metabolism of these nutrients. While encouraging, much more research is needed to better understand how timed administration of these nutrients and others may impact performance, health, or other exercise training outcomes.


Assuntos
Desempenho Atlético/fisiologia , Exercício Físico , Micronutrientes/administração & dosagem , Substâncias para Melhoria do Desempenho/administração & dosagem , Fenômenos Fisiológicos da Nutrição Esportiva , Cafeína/administração & dosagem , Cálcio na Dieta/administração & dosagem , Creatina/administração & dosagem , Humanos , Ferro/administração & dosagem , Nitratos/administração & dosagem , Bicarbonato de Sódio/administração & dosagem , Fatores de Tempo , beta-Alanina/administração & dosagem
16.
J Int Soc Sports Nutr ; 16(1): 41, 2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-31533750

RESUMO

BACKGROUND: Previous studies have shown that sodium bicarbonate ingestion may enhance intense exercise performance, but may also cause severe gastrointestinal distress. The purpose of this study was to determine whether a modified sodium bicarbonate (SB) ingestion protocol would elevate serum bicarbonate concentration more than previous methods without causing gastrointestinal distress. METHODS: In randomized order, seven (5 men, 2 women) elite middle-distance runners ingested either placebo, Modified SB (600 mg·kg- 1 over 19.5 h), or Acute SB (300 mg·kg- 1) in opaque gelatin capsules. Baseline and post-ingestion blood samples were analyzed for bicarbonate, pH, sodium, hematocrit, and lactate. Repeated measures ANOVA (2 time points × 3 conditions) were analyzed to determine differences in serum bicarbonate, lactate, sodium, blood pH, and hematocrit. Gastrointestinal distress was assessed via self-report on a Likert scale of 1-10. Simple (condition) and repeated (time) within-participant contrasts were used to determine the location of any statistically significant main and interaction effects (p ≤ 0.05). RESULTS: Both Modified SB (7.6 mmol·L- 1, p < 0.01) and Acute SB (5.8 mmol·L- 1, p < 0.01) increased serum bicarbonate concentration compared to the placebo (p ≤ 0.05). Post-ingestion serum bicarbonate concentration was significantly higher for the Modified SB (34.7 ± 2.2 mmol·L- 1, 28.0% increase) trials than the Acute SB (33.5 ± 2.0 mmol·L- 1, 20.9% increase) trials (p = 0.05). There was no reported severe GI distress in the Modified SB trials, but two cases in the Acute SB trials. CONCLUSIONS: Modified SB elevated serum bicarbonate concentration more than Acute SB, without any severe gastrointestinal side effects. Consequently, it is recommended that future experimentation involving SB by researchers and athletes use the novel ingestion protocol described in this study due to its potential for improved effectiveness and reduced gastrointestinal impact. TRIAL REGISTRATION: ClinicalTrials.gov , NCT03813329 . Registered 23 January 2019 - Retrospectively registered.


Assuntos
Bicarbonatos/sangue , Corrida , Bicarbonato de Sódio/administração & dosagem , Adulto , Atletas , Feminino , Gastroenteropatias , Hematócrito , Humanos , Concentração de Íons de Hidrogênio , Ácido Láctico/sangue , Masculino , Sódio/sangue , Adulto Jovem
17.
Int J Sports Med ; 40(11): 711-716, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31434137

RESUMO

The purpose of this study was to evaluate whether NaHCO3, administered via a 9-h stacked loading protocol (i.e. repeated supplementation with small doses in order to obtain a gradual increase in blood [HCO3 -]), has an ergogenic effect on repeated all-out exercise. Twelve physically active males were randomly assigned to receive either NaHCO3 (BIC) or placebo (PL) in a double-blind cross-over design. NaHCO3 supplementation was divided in three identical 3-h cycles: a 6.3 g bolus at the start, followed by 2.1 g doses at +1-h and +2-h, yielding a total NaHCO3 intake of 0.4 g·kg-1 BM over 9-h. At the end of each cycle, participants performed 2-min all-out cycling. Capillary blood samples were analyzed for [HCO3 -], pH and [La-]. Pre-exercise blood [HCO3 -] in PL decreased from 25.6±0.2 mmol·L-1 in bout 1 to 23.6±0.2 mmol·L-1 in bout 4, while increasing from 25.5±0.2 to 31.2±0.4 mmol·L-1 in BIC (P<0.05). Concomitantly, pre-exercise pH values gradually decreased in PL (from 7.41±0.00 to 7.39±0.01) and increased in BIC (from 7.41±0.01 to 7.47±0.01; P<0.05). Mean power output of the four bouts was higher in BIC (428±20 W) than in PL (420±20 W; P<0.05). The ergogenic effect on repeated all-out exercise occurred in the absence of gastrointestinal distress.


Assuntos
Desempenho Atlético/fisiologia , Substâncias para Melhoria do Desempenho/administração & dosagem , Bicarbonato de Sódio/administração & dosagem , Estudos Cross-Over , Método Duplo-Cego , Esquema de Medicação , Teste de Esforço , Gastroenteropatias/induzido quimicamente , Humanos , Concentração de Íons de Hidrogênio , Ácido Láctico/sangue , Masculino , Substâncias para Melhoria do Desempenho/efeitos adversos , Substâncias para Melhoria do Desempenho/sangue , Bicarbonato de Sódio/efeitos adversos , Bicarbonato de Sódio/sangue , Adulto Jovem
19.
Neth J Med ; 77(5): 186-188, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31264584

RESUMO

We describe a 27-year-old female with repeated episodes of pulseless electrical activity due to intoxication with a substance that was unidentified at presentation. Severe QRS widening was observed and empiric treatment with sodium bicarbonate and intravenous lipid emulsion was administered. In this case, intraosseous administration of lipid emulsion failed to improve haemodynamic parameters, suggesting that this dose remained in the bone marrow compartment. We recommend that physicians become aware of this possibility and to avoid intraosseous administration of lipid emulsion.


Assuntos
Gluconato de Cálcio/administração & dosagem , Cloroquina/toxicidade , Overdose de Drogas , Emulsões Gordurosas Intravenosas/administração & dosagem , Parada Cardíaca , Bicarbonato de Sódio/administração & dosagem , Adulto , Antimaláricos/toxicidade , Tampões (Química) , Fármacos Cardiovasculares/administração & dosagem , Cuidados Críticos/métodos , Overdose de Drogas/diagnóstico , Overdose de Drogas/etiologia , Overdose de Drogas/fisiopatologia , Overdose de Drogas/terapia , Eletrocardiografia/métodos , Feminino , Parada Cardíaca/induzido quimicamente , Parada Cardíaca/diagnóstico , Parada Cardíaca/terapia , Humanos , Infusões Intraósseas/métodos , Tentativa de Suicídio , Resultado do Tratamento
20.
Neth J Med ; 77(5): 189-192, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31264585
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