Brain pH effects of NaHCO3 and Carbicarb® in lactic acidosis

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Abstract
The effects of iv sodium bicarbonate (NaHCO3) and Carbicarb®, an experimental buffer, were compared in a rat model of lactic acidosis induced by controlled hemorrhage and asphyxia. Although both NaHCO3 and Carbicarb were effective at alkalinizing the arterial blood in this model, NaHCO3 administration resulted in a rise in Paco2 where Carbicarb did not (+9 ± 2 vs. +2 ± 2 torr at 2 min after infusion, p < .01). Moreover, NaHCO3 resulted in a small decrease in intracellular brain pH as measured with P-31 nuclear magnetic resonance where Carbicarb afforded intracellular brain alkalinization (-0.03 ± 0.01 vs. +0.08 ± 0.02 pH units at 2 min, p < .01). If these data are confirmed clinically. Carbicarb may offer advantages over NaHCO3 under conditions of fixed or limited ventilation.