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Although sodium bicarbonate is usually administered during cardiac arrest, its use is controversial, in part because of difficulties in performing good studies on cardiac-arrest victims. To gain insight into the effects of bicarbonate, these investigators studied ten patients with severe heart failure on the assumption that they were reasonable proxies for patients in arrest. All patients received an infusion of bicarbonate and a control infusion of sodium chloride in randomized order. Blood gases, 2,3- diphosphoglyceric acid, glucose, lactate, cardiac hemodynamics, and oxygen consumption were measured after each infusion.
Bicarbonate administration resulted in a significant and substantial fall in arterial oxygen tension, myocardial oxygen …