Hemodynamic consequences of severe lactic acidosis in shock states: from bench to bedside

Kimmoun, Antoine; Novy, Emmanuel; Auchet, Thomas; Ducrocq, Nicolas; Levy, Bruno

doi:10.1186/s13054-015-0896-7

Critical Care

Table 1 Reported effects of Sodium Bicarbonate on intracellular and extracellular pH, hemodynamics and mortality in in vivo experimental and clinical studies

From: Hemodynamic consequences of severe lactic acidosis in shock states: from bench to bedside

Study	Experimental (E) or human (H)	Methodology (intervention/subjects/protocol/measurements)	Increased PaCO ₂ after alkalinization in HCO ₃ ⁻ group?	Decreased or unchanged pHe or pHi after alkalinization in HCO ₃ ⁻ group or compared with other groups?	Shock associated lactic acidosis?	Positive effects of sodium bicarbonate on hemodynamics (arterial pressure/ cardiac index) ^a	Positive impact of sodium bicarbonate on mortality ^b
Kim *et al* . 2013 [112]	H	Retrospective. 103 patients with lactic acidosis. Effects of HCO₃ ⁻ on survival	NA	NA	Yes	NA	NA
Wilson *et al* . 2013 [81]	H	Retrospective series. Severe acidotic trauma patients. Effects of HCO₃ ⁻ on survival, PaCO₂, pH	Yes	pHe: no	Yes	NA	NA
Wilson *et al* . 2013 [81]	H		Yes	pHi: NA.	Yes	NA	NA
Levraut *et al* . 2000 [113]	H	Mild metabolic acidosis in non-shock patients. Effects of a bicarbonate load on CO₂ generation depending on non-bicarbonate buffer	Yes	pHe: no	No	NA	NA
Levraut *et al* . 2000 [113]	H		Yes	pHi: no	No	NA	NA
Nielsen *et al* . 2002 [114]	H	5-minute rhythmic handgrip to provoke intracellular acidosis. Healthy subjects. HCO₃ ⁻ vs. saline. Effect on arterial pH, and muscle pHi, PaCO₂	Yes	pHe: no	No	NA	NA
Nielsen *et al* . 2002 [114]	H		Yes	pHi: no	No	NA	NA
Nakashima *et al* . 1996 [115]	H	Healthy subjects. Effects of HCO₃ ⁻ infusion on cerebral blood flow, PaCO₂ and pHi	Yes	pHe: no	No	NA	NA
Nakashima *et al* . 1996 [115]	H		Yes	pHi: yes	No	NA	NA
Leung *et al* . 1994 [100]	H	Metabolic acidosis in patients undergoing surgery. HCO₃ ⁻ vs. carbicarb. Effects on pHe, hemodynamics	NA	pHe: no	No	No	NA
Leung *et al* . 1994 [100]	H		NA	pHi: NA	No	No	NA
Mark *et al* . 1993 [116]	H	Intraoperative mild acidosis. HCO₃ ⁻ vs. saline. Effects on PaCO₂, pH, hemodynamics	Yes	pHe: no	No	NA	NA
Mark *et al* . 1993 [116]	H		Yes	pHi: NA	No	NA	NA
Fanconi *et al* . 1993 [117]	H	Neonatal acidosis. HCO₃ ⁻ before-after study. Effect on hemodynamics, pH, PaCO₂, PtCO₂	Yes	pHe: no	Yes	Yes	NA
Fanconi *et al* . 1993 [117]	H		Yes	pHi: NA	Yes	Yes	NA
Mathieu *et al* . 1991 [92]	H	Septic shock. HCO₃ ⁻ vs. saline. Effect on arterial pH, PaCO₂, hemodynamics	Yes	pHe: no	Yes	No	NA
Mathieu *et al* . 1991 [92]	H		Yes	pHi: NA	Yes	No	NA
Cooper *et al* . 1990 [89]	H	Septic shock. HCO₃ ⁻ vs. saline. Effect on arterial pH, PaCO₂, hemodynamics	Yes	pHe: no	Yes	No	NA
Cooper *et al* . 1990 [89]	H		Yes	pHi: NA	Yes	No	NA
Bersin *et al* . 1989 [118]	H	Congestive heart disease. HCO₃ ⁻ vs. saline. Effect on acidosis, PaCO₂, hemodynamics (myocardial oxygen consumption)	Yes	pHe: no	No	No	NA
Bersin *et al* . 1989 [118]	H		Yes	pHi: NA	No	No	NA
Kimmoun *et al* . 2014 [60]	E	Hemorrhagic shock. Rats. HCO₃ ⁻ with calcium adjunction and increased respiratory rate. Effect on pHe, muscle pHi, hemodynamics	No	pHe: No	Yes	Yes	NA
Kimmoun *et al* . 2014 [60]	E		No	pHi: No	Yes	Yes	NA
Valenza *et al* . 2012 [84]	E	Lactic acid infusion. Rats. Lactic acidosis vs. lactic acidosis + sodium bicarbonate. Effects on hemodynamics, pHe, lactate, phosphofructokinase.	Yes	pHe: No	No	No	NA
Valenza *et al* . 2012 [84]	E		Yes	pHi: NA	No	No	NA
Beech *et al* . 1994 [87]	E	Hypovolemic shock. Rats. Carbicarb vs. HCO₃ ⁻. Muscle pHi, PaCO2 and hemodynamics	Yes	pHe: No	Yes	No	NA
Beech *et al* . 1994 [87]	E		Yes	pHi: Yes	Yes	No	NA
Bollaert *et al* . 1994 [79]	E	Endotoxinic shock. Rats. HCO₃ ⁻ vs. saline. Effect on arterial pH, PaCO_2, muscle pHi, hemodynamics	Yes	pHe: No	Yes	No	NA
Bollaert *et al* . 1994 [79]	E		Yes	pHi: Yes	Yes	No	NA
Rhee *et al* . 1993 [83]	E	Hypoxic lactic acidosis. Mongrel dogs. HCO₃ ⁻ vs. Carbicarb vs. saline. Effects on PaCO₂, hemodynamics	Yes	pHe: Yes	Yes	No	NA
Rhee *et al* . 1993 [83]	E		Yes	pHi: Yes	Yes	No	NA
Cooper *et al* . 1993 [88]	E	L-lactic infusion. Pigs. HCO₃ ⁻ vs. saline. Effects on pH, hemodynamics	Per protocol ventilation adjustment	pHe: No	Yes	No	NA
Cooper *et al* . 1993 [88]	E		Per protocol ventilation adjustment	pHi: NA.	Yes	No	NA
Shapiro *et al* . 1990 [119]	E	Ammonium chloride-induced metabolic acidosis. HCO₃ ⁻ vs. Carbicarb. Effects on PaCO₂, pHe, hepatic pHi, hemodynamics	Yes	pHe: No	No	No	NA
Shapiro *et al* . 1990 [119]	E		Yes	pHi: Yes	No	No	NA
Dimlich *et al* . 1988 [120]	E	Low-flow-induced lactic acidosis. Rats. HCO₃ ⁻ vs. NaDCA vs. NaCl. Effects on pH, lactatemia	NA	pHe: No	Yes	No	NA
Dimlich *et al* . 1988 [120]	E		NA	pHi: NA.	Yes	No	NA
Iberti *et al* . 1988 [91]	E	Hemorrhagic shock. Dogs. HCO₃ ⁻ vs. saline. Effect on hemodynamics, pH, PaCO₂	Yes	pHe: Yes	Yes	No	NA
Iberti *et al* . 1988 [91]	E		Yes	pHi: NA.	Yes	No	NA
Hope *et al* . 1988 [121]	E	Incomplete cerebral ischemia in lamb. Effects of glucose and HCO₃ ⁻ on cerebral pHi, PaCO₂ and PtiCO₂	Yes	pHe: No	No	NA	NA
Hope *et al* . 1988 [121]	E		Yes	pHi: Yes	No	NA	NA
Sessler *et al* . 1987 [122]	E	Lactic acidosis treatment in neonatal rabbits. Effect of HCO₃ ⁻ on pHi and pHe and PaCO₂	Yes	pHe: no	Yes	NA	NA
Sessler *et al* . 1987 [122]	E		Yes	pHi: no	Yes	NA	NA
Graf *et al* . 1985 [90]	E	Hypoxic lactic acidosis. Dogs. HCO₃ ⁻ vs. saline vs. no therapy. Effects on pHe and hemodynamics	NA	pHe: yes	Yes	No	No
Graf *et al* . 1985 [90]	E		NA	pHi: NA	Yes	No	No
Graf *et al* . 1985 [123]	E	Hypoxic lactic acidosis. Dogs. HCO₃ ⁻ vs. saline. Effects on pHe and hepatic pHi	Yes	pHe: yes	Yes	No	No
Graf *et al* . 1985 [123]	E		Yes	pHi: yes	Yes	No	No
Arieff *et al* . 1982 [82]	E	Phenformin-induced lactic acidosis. Dogs. HCO₃ ⁻ vs. saline vs. placebo. Effects on pHe, pHi, hemodynamics	NA	pHe: yes	Yes	No	No
Arieff *et al* . 1982 [82]	E		NA	pHi: yes	Yes	No	No

^aOnly applicable in comparative studies with critical patients or experimental models. ^bOnly applicable in comparative studies with critical patients or experimental models. NA, not applicable; pHe, extracellular pH; pHi, intracellular pH.

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