Abstract
This therapeutic trial of rapid alkali therapy immediately after birth was initiated because of 1. the observation that prognosis in respiratory distress syndrome (RDS) is worse the longer that acidosis persists, as well as 2. the recently proposed hypothesis that the pathogenesis of RDS may be pulmonary hypoperfusion caused by hypoxemia and acidosis. From 1960–1964, and again in 1966, consecutively delivered infants with RDS were treated with slow drip infusions of sodium bicarbonate (5–15 mEq/100 ml 10 % G/W, at 65 ml/kg/day until capillary pH rose to 7.35 (Pediat. Clin. N. Amer. 8: 525 [1961]). In 1965 a trial of rapid correction of acidosis was made in which pH was corrected up to 7.35 within 3 h of birth, using a solution of 20 mEq Na bicarb/100 ml 10% G/W. The rates of flow ranged from 10–50 ml/kg/3 h. Other than rapidity of alkali administration, therapy was similar to that used before and after.
Mortality in RDS infants weighing 1001–2500 g was 61 out of 257 (23.7 %) with slow correction, and 16 out of 41 infants (39.0 %) with rapid correction (P < 0.05). (SPR)
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Usher, R. 83 Comparison of Rapid Versus Gradual Correction of Acidosis in RDS of Prematurity. A Sequential Study. Pediatr Res 1, 221 (1967). https://doi.org/10.1203/00006450-196705000-00090
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DOI: https://doi.org/10.1203/00006450-196705000-00090
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