The Effect of Bicarbonate Administration via Continuous Venovenous Hemofiltration on Acid-Base Parameters in Ventilated PatientsReportar como inadecuado

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BioMed Research International - Volume 2015 2015, Article ID 901590, 8 pages -

Research Article

Division of Nephrology, Department of Medicine, Massachusetts General Hospital, 7 Whittier Place, Suite 106, Boston, MA 02114, USA

Division of Nephrology and Hypertension, Department of Medicine and Genetics, UNC School of Medicine, UNC Kidney Center, 7024 Burnett-Womack, CB No. 7155, Chapel Hill, NC 27599-7155, USA

Renal Division, Department of Medicine, Brigham and Women’s Hospital, 75 Francis Street, MRB4, Boston, MA 02115, USA

Received 2 October 2014; Revised 8 December 2014; Accepted 22 December 2014

Academic Editor: Boris Jung

Copyright © 2015 Andrew S. Allegretti et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Acute kidney injury AKI and metabolic acidosis are common in the intensive care unit. The effect of bicarbonate administration on acid-base parameters is unclear in those receiving continuous venovenous hemofiltration CVVH and mechanical ventilatory support. Methods. Metabolic and ventilatory parameters were prospectively examined in 19 ventilated subjects for up to 96 hours following CVVH initiation for AKI at an academic tertiary care center. Mixed linear regression modeling was performed to measure changes in pH, partial pressure of carbon dioxide pCO2, serum bicarbonate, and base excess over time. Results. During the 96-hour study period, pCO2 levels remained stable overall initial pCO2 42.0 ± 14.6 versus end-study pCO2 43.8 ± 16.1 mmHg; for interaction with time, for those with initial pCO2 ≤40 mmHg 31.3 ± 5.7 versus 35.0 ± 4.8; and for those with initial pCO2 >40 mmHg 52.7 ± 12.8 versus 53.4 ± 19.2; . pCO2 decreased during the immediate hours following CVVH initiation 42.0 ± 14.6 versus 37.3 ± 12.6 mmHg, though this change was nonsignificant . Conclusions. We did not detect a significant increase in pCO2 in response to the administration of bicarbonate via CVVH in a ventilated population. Additional studies of larger populations are needed to confirm this finding.

Autor: Andrew S. Allegretti, Jennifer E. Flythe, Vinod Benda, Emily S. Robinson, and David M. Charytan



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