Indications for the Use of Sodium Bicarbonate in the Treatment of Intractable Asthma

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Abstract
When status asthmaticus is refractory to bronchodilators and has resulted in respiratory acidosis, the correction of acidemia by the intravenous administration of NaHCO3 relieves bronchospasm and restores responsiveness to epinephrine. 3Frequency of administration should be determined by repeated analysis of arterial pH and PCO2. The recommended single dose is 1.5 mEq/kg intravenously. Six cases are presented illustrating this, among them a 12-year-old child who, by this therapy, recovered from an attack of asthma which had lowered her arterial pH to 6.66. By this approach, the use of mechanical ventilation is used, correction of acidemia lowers airway resistance and allows more effective ventilation at lower, and safer, inspiratory pressures. The coexistence of congestive heart failure does not appear to be a contraindication to this therapy.

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