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Metabolic acidosis in childhood: why, when and how to treat.

Authors
  • Andrade, Olberes V B
  • Ihara, Flávio O
  • Troster, Eduardo J
Type
Published Article
Journal
Jornal de pediatria
Publication Date
May 01, 2007
Volume
83
Issue
2 Suppl
Identifiers
PMID: 17508091
Source
Medline
License
Unknown

Abstract

Despite the known effects of acidemia on the organism in critical situations, a protective role of acidemia in hypoxic cells and the risk of alkalemia secondary to drug interventions are being considered. There is consensus regarding the advantages of alkali and sodium bicarbonate therapy in cases with normal anion gap; however, in the presence of high anion gap acidosis, especially lactic acidosis, diabetic acidosis and cardiopulmonary resuscitation, the use of sodium bicarbonate is not beneficial and has potential adverse effects, limiting its indication. The only points of agreement in the literature refer to the early treatment of the underlying disease and the mechanisms generating metabolic acidemia. Other promising treatment alternatives have been proposed; however, the side effects and absence of controlled studies with pediatric populations translate into lack of evidence to support the routine use of such treatments.

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