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PloS One 2021Oral bicarbonate solution is known to improve both maternal and perinatal outcomes among women with abnormal labour (dystocia). Its effectiveness and safety among women... (Randomized Controlled Trial)
Randomized Controlled Trial
Effect of pre-operative bicarbonate infusion on maternal and perinatal outcomes among women with obstructed labour in Mbale hospital: A double blind randomized controlled trial.
INTRODUCTION
Oral bicarbonate solution is known to improve both maternal and perinatal outcomes among women with abnormal labour (dystocia). Its effectiveness and safety among women with obstructed labour is not known.
OBJECTIVE
To determine the effect and safety of a single-dose preoperative infusion of sodium bicarbonate on maternal and fetal blood lactate and clinical outcomes among women with obstructed labour (OL) in Mbale hospital.
METHODS
We conducted a double blind, randomised controlled trial from July 2018 to September 2019. The participants were women with OL at term (≥37 weeks gestation), carrying a singleton pregnancy with no other obstetric emergency, medical comorbidity or laboratory derangements.
INTERVENTION
A total of 477 women with OL were randomized to receive 50ml of 8.4% sodium bicarbonate (238 women) or 50 mL of 0.9% sodium chloride (239 women). In both the intervention and controls arms, each participant was preoperatively given a single dose intravenous bolus. Every participant received 1.5 L of normal saline in one hour as part of standard preoperative care.
OUTCOME MEASURES
Our primary outcome was the mean difference in maternal venous blood lactate at one hour between the two arms. The secondary outcomes were umbilical cord blood lactate levels at birth, neonatal sepsis and early neonatal death upto 7 days postnatal, as well as the side effects of sodium bicarbonate, primary postpartum hemorrhage, maternal sepsis and mortality at 14 days postpartum.
RESULTS
The median maternal venous lactate was 6.4 (IQR 3.3-12.3) in the intervention and 7.5 (IQR 4.0-15.8) in the control group, with a statistically non-significant median difference of 1.2 mmol/L; p-value = 0.087. Vargha and Delaney effect size was 0.46 (95% CI 0.40-0.51) implying very little if any effect at all.
CONCLUSION
The 4.2g of preoperative intravenous sodium bicarbonate was safe but made little or no difference on blood lactate levels.
TRIAL REGISTRATION
PACTR201805003364421.
Topics: Adult; Bicarbonates; Delivery, Obstetric; Dose-Response Relationship, Drug; Double-Blind Method; Dystocia; Female; Humans; Lactic Acid; Mothers; Pregnancy; Preoperative Period; Safety; Uganda; Umbilical Cord; Young Adult
PubMed: 33561141
DOI: 10.1371/journal.pone.0245989 -
Intensive Care Medicine Mar 2020
Topics: Bicarbonates; Hydrogen-Ion Concentration; Intensive Care Units; Sodium Bicarbonate
PubMed: 31728566
DOI: 10.1007/s00134-019-05842-4 -
Clinical Journal of the American... Feb 2021
Topics: Acidosis; Ammonium Compounds; Animals; Bicarbonates; Citric Acid; Disease Progression; Humans; Hydrogen-Ion Concentration; Renal Insufficiency, Chronic
PubMed: 32769096
DOI: 10.2215/CJN.07990520 -
Critical Care and Resuscitation :... Mar 2020The benefit of intravenous sodium bicarbonate administration in patients with severe metabolic acidosis remains controversial, partly due to lack of double-blind trials....
BACKGROUND
The benefit of intravenous sodium bicarbonate administration in patients with severe metabolic acidosis remains controversial, partly due to lack of double-blind trials. From a practical viewpoint, such blinding requires testing of the stability of sodium bicarbonate in polyolefin bags.
METHODS
We examined seven samples of 100 mL 8.4% sodium bicarbonate diluted in 150 mL normal saline within a 250 mL polyolefin bag at time 0, 24 and 48 hours after preparation. We measured pH, Pco, and bicarbonate concentration.
RESULTS
Over a period of 48 hours, both pH and Pco decreased significantly (hourly rate of change, -0.001 [ = 0.043) and -0.098 [ < 0.001] respectively). However, the concentration of bicarbonate did not decrease, with an hourly rate of change of only -0.009 ( = 0.42).
CONCLUSION
When 100 mL of 8.4% sodium bicarbonate are diluted in 150 mL of normal saline within a 250 mL polyolefin bag, changes in pH and Pco over a 48-hour period are small and bicarbonate concentration remains stable.
Topics: Bicarbonates; Drug Stability; Humans; Hydrogen-Ion Concentration; Saline Solution; Sodium Bicarbonate
PubMed: 32102647
DOI: 10.51893/2020.1.tn2 -
Seminars in Dialysis 2014
Topics: Bicarbonates; Humans; Kidney Failure, Chronic; Renal Dialysis
PubMed: 25204882
DOI: 10.1111/sdi.12253 -
Biochimica Et Biophysica Acta Aug 2012In photosynthesis, cyanobacteria, algae and plants fix carbon dioxide (CO(2)) into carbohydrates; this is necessary to support life on Earth. Over 50 years ago, Otto... (Review)
Review
In photosynthesis, cyanobacteria, algae and plants fix carbon dioxide (CO(2)) into carbohydrates; this is necessary to support life on Earth. Over 50 years ago, Otto Heinrich Warburg discovered a unique stimulatory role of CO(2) in the Hill reaction (i.e., O(2) evolution accompanied by reduction of an artificial electron acceptor), which, obviously, does not include any carbon fixation pathway; Warburg used this discovery to support his idea that O(2) in photosynthesis originates in CO(2). During the 1960s, a large number of researchers attempted to decipher this unique phenomenon, with limited success. In the 1970s, Alan Stemler, in Govindjee's lab, perfected methods to get highly reproducible results, and observed, among other things, that the turnover of Photosystem II (PSII) was stimulated by bicarbonate ions (hydrogen carbonate): the effect would be on the donor or the acceptor, or both sides of PSII. In 1975, Thomas Wydrzynski, also in Govindjee's lab, discovered that there was a definite bicarbonate effect on the electron acceptor (the plastoquinone) side of PSII. The most recent 1.9Å crystal structure of PSII, unequivocally shows HCO(3)(-) bound to the non-heme iron that sits in-between the bound primary quinone electron acceptor, Q(A), and the secondary quinone electron acceptor Q(B). In this review, we focus on the historical development of our understanding of this unique bicarbonate effect on the electron acceptor side of PSII, and its mechanism as obtained by biochemical, biophysical and molecular biological approaches in many laboratories around the World. We suggest an atomic level model in which HCO(3)(-)/CO(3)(2-) plays a key role in the protonation of the reduced Q(B). In addition, we make comments on the role of bicarbonate on the donor side of PSII, as has been extensively studied in the labs of Alan Stemler (USA) and Vyacheslav Klimov (Russia). We end this review by discussing the uniqueness of bicarbonate's role in oxygenic photosynthesis and its role in the evolutionary development of O(2)-evolving PSII. This article is part of a Special Issue entitled: Photosynthesis Research for Sustainability: from Natural to Artificial.
Topics: Bicarbonates; Photosynthesis; Photosystem II Protein Complex
PubMed: 22521596
DOI: 10.1016/j.bbabio.2012.04.003 -
Journal of Dairy Science Jun 1980Twenty cows were in an experiment to measure effects of dietary buffers, sodium bicarbonate and magnesium oxide, on ration adjustment and incidence of metabolic problems...
Twenty cows were in an experiment to measure effects of dietary buffers, sodium bicarbonate and magnesium oxide, on ration adjustment and incidence of metabolic problems in the first 8 wk postpartum. Cows were fed 2.7 kg grain per day and alfalfa ad libitum prepartum and switched immediately to a complete ration of 40% corn silage and 60% concentrate (dry matter) postpartum. Treatments included 1.5% sodium bicarbonate and .8% magnesium oxide (total ration dry matter) fed in a 2 x 2 factorial arrangement. Cows receiving bicarbonate peaked 2 to 3 wk earlier in intake and averaged 2.1 kg per day greater intake than those fed the control diet. Actual milk production was increased by sodium bicarbonate with greatest differences for cows receiving both buffers averaging 3.8 kg per day more milk than control cows. Increases over co ntrols were 2.6 and 5.6 kg fat-corrected milk per day for cows receiving sodium bicarbonate alone or in combination with magnesium oxide, respectively. Sodium bicarbonate increased acetate to propionate molar ratios in rumen samples taken at 1 and 2 wk postpartum whereas neither buffer had any effect on rumen pH. Blood hematocrit and urine pH were not affected by treament. Magnesium oxide increased fecal pH .8 units and slightly decreased fecal starch, but sodium bicarbonate had no effect.
Topics: Animals; Bicarbonates; Cattle; Female; Labor, Obstetric; Lactation; Magnesium Oxide; Pregnancy; Sodium
PubMed: 7190580
DOI: 10.3168/jds.S0022-0302(80)83027-X -
Journal of Dairy Science Nov 1984Objectives were to study effects of heat stress, 0 or .85% sodium bicarbonate, 0 or 1.0% potassium bicarbonate, and 1.0 or 1.5% total dietary potassium on production and...
Objectives were to study effects of heat stress, 0 or .85% sodium bicarbonate, 0 or 1.0% potassium bicarbonate, and 1.0 or 1.5% total dietary potassium on production and physiological responses of dairy cows. Eighteen lactating Holsteins were assigned to shade (control) or no shade (heat stress) lots continuously for three consecutive 35-day periods and to different dietary treatments each period. Basal diet was 25% cottonseed hulls and 75% concentrate. Daytime and nighttime feed intake and production were measured the last 2 wk of each period, and milk and blood were sampled the final day of each period. Black globe temperature, rectal temperature, respiration rate, and blood pH were higher in no shade. Daytime intake was 132% greater in shade, nighttime intake was not different between environments. Milk production was about 19% greater for evening and morning milkings in shade. Daytime intake, daytime and nighttime milk production were higher with sodium bicarbonate. Potassium bicarbonate reduced intake and production. Higher total dietary potassium increased total daily milk production. Lactating cows appear adept at withstanding environmental and dietary challenges to acid-base homeostasis. Supplementation of sodium bicarbonate and 1.5% dietary potassium, but not potassium bicarbonate, were beneficial to lactating dairy cows.
Topics: Animals; Bicarbonates; Blood Gas Analysis; Body Temperature; Cattle; Cattle Diseases; Female; Food, Fortified; Hot Temperature; Lactation; Milk; Potassium; Potassium Compounds; Pregnancy; Rectum; Respiration; Sodium Bicarbonate; Stress, Physiological
PubMed: 6097604
DOI: 10.3168/jds.S0022-0302(84)81611-2 -
Kidney International Jul 1984To test the contribution of bicarbonate (Bi) to hemodynamic stability during hemodialysis (HD), we compared the effects of ultrafiltration dialysis with bicarbonate and... (Clinical Trial)
Clinical Trial Comparative Study
To test the contribution of bicarbonate (Bi) to hemodynamic stability during hemodialysis (HD), we compared the effects of ultrafiltration dialysis with bicarbonate and with acetate under conditions of high-sodium (141 mEq/liter) and low-sodium (130 mEq/liter) dialysate concentrations in 12 stable HD patients. Group 1 was patients (N = 5) who had normal findings on autonomic testing; group 2, patients (N = 7) who had abnormal findings on autonomic testing. All patients and staff were unaware of which dialysis was being used. During the high-sodium dialysate studies, changes in mean blood pressure (MBP), cardiac output (CO), and orthostatic tolerance to standing after HD were similar in both groups of patients with both acetate and bicarbonate dialysate. When the studies were repeated under low-sodium dialysate conditions, several differences emerged between acetate and bicarbonate HD. In group 1, the frequency of adverse symptoms upon standing after HD were reduced with bicarbonate (P less than 0.05). In group 2, bicarbonate HD prevented a significant decrease in orthostatic MBP after HD. These results suggest that bicarbonate affords no greater hemodynamic stability than does acetate if a dialysate sodium of 141 mEq/liter is used. With lower sodium dialysate, bicarbonate appears to provide a modest improvement in decreasing orthostatic symptoms and signs in patients with and without autonomic insufficiency.
Topics: Acetates; Adult; Aged; Autonomic Nervous System Diseases; Bicarbonates; Blood Pressure; Body Weight; Cardiac Output; Hemodynamics; Humans; Male; Middle Aged; Prospective Studies; Renal Dialysis; Sodium
PubMed: 6482180
DOI: 10.1038/ki.1984.134 -
BMJ (Clinical Research Ed.) Jun 1993
Topics: Bicarbonates; Cardiopulmonary Resuscitation; Europe; Humans; Inservice Training; Lidocaine; Practice Guidelines as Topic; Sodium; Sodium Bicarbonate
PubMed: 8392412
DOI: 10.1136/bmj.306.6892.1555