Intravenous sodium bicarbonate verifies intravenous position of catheters in ventilated children

Anesthesia and Analgesia
Ilan KeidanHaim Berkenstadt

Abstract

Vascular access in children carries a significant risk of accidental extravasation of IV fluids and medications with the potential for tissue injury. In this prospective controlled study we assessed the diagnostic utility of using IV diluted sodium bicarbonate to confirm placement of IV catheters in ventilated children. Diluted sodium bicarbonate was created using undiluted standard 8.4% (1 mEq/mL) sodium bicarbonate mixed in a 1:3 and 1:5 ratio with sterile water to achieve a final diluted concentration of 2.1% (0. 25 mEq/mL) and 1.05% (0.125 mEq/mL) sodium bicarbonate, respectively. In 18 ASA I-II mechanically ventilated children ages 1 to 8 years, the effects of 1 mL/kg of dilute 2.1%, 1.05% sodium bicarbonate, or 0.9% normal saline, injected in a randomized order, were analyzed. All children had oxygen saturation, arterial blood pressure, electrocardiograph, and end-tidal carbon dioxide (ETCO(2)) monitoring. In addition, venous blood samples were taken before injection and 10 minutes after the final injection for analysis of venous blood pH and electrolytes. In children, IV diluted 2.1% sodium bicarbonate resulted in significantly increased etco(2) (mean of 32.8 ± 3.4 mm Hg to 39.0 ± 3.5 mm Hg, P < 0.001), a mean increase o...Continue Reading

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Jun 7, 2011·Anesthesia and Analgesia·Ilan KeidanHaim Berkenstadt

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