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March 1979

Alteration of Oxygen Tension and Oxyhemoglobin SaturationA Hazard of Sodium Bicarbonate Administration

Author Affiliations

From the Departments of Anesthesiology (Drs Douglas, Downs, and Mantini and Mr Ruiz) and Surgery (Drs Douglas and Downs), University of Florida College of Medicine, Gainesville, Fla.

Arch Surg. 1979;114(3):326-329. doi:10.1001/archsurg.1979.01370270096018

• The administration of sodium bicarbonate solution, which has been advocated for the treatment of metabolic acidosis, may have detrimental side effects. We evaluated oxyhemoglobin saturation and oxygen tensions in eight anesthetized swine before and after freshwater near-drowning and after a rapid intravenous infusion of 7.5% sodium bicarbonate solution (8 mEq/kg).

After freshwater aspiration, arterial and venous oxygen tensions and oxyhemoglobin saturation decreased. Administration of sodium bicarbonate resulted in decreased venous and increased arterial, oxygen tensions. Arterial, but not venous, oxyhemoglobin saturation increased. These findings suggest that sodium bicarbonate caused a distinct leftward shift in the oxyhemoglobin dissociation curve, which could impair tissue oxygenation. Therefore, to avoid detrimental effects, sodium bicarbonate should be administered slowly and in a dose sufficient just to correct metabolic acidosis.

(Arch Surg 114:326-329, 1979)