Sodium Bicarbonate Use in the Treatment of Acute Neonatal Lactic Acidosis: Benefit or Harm?

It is clear that profound and prolonged metabolic acidosis leads to short- and long-term morbidity and mortality. Effective treatment would be to eliminate the cause of the acidosis. The primary cause of lactic acidosis is inadequate oxygen delivery to the tissues resulting from inadequate ventilation, inadequate oxygen-carrying capacity, or inadequate oxygen delivery to the tissues. Therefore, the goal of treatment during resuscitation is establishing adequate ventilation, providing oxygen, improving perfusion with volume, and treating anemia. Although severe metabolic acidosis requires time to reverse despite adequate treatment, the evidence against use of sodium bicarbonate for hypoxic metabolic acidosis is convincing. © 2011 Springer PublishingCompany.