{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T10:05:26Z","timestamp":1791281126525,"version":"4.1.0"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2014,4]]},"abstract":"Abstract<\/jats:title>\n \n Background:<\/jats:title>\n Lactic acidosis is associated with cardiovascular failure. Buffering with sodium bicarbonate is proposed in severe lactic acidosis. Bicarbonate induces carbon dioxide generation and hypocalcemia, both cardiovascular depressant factors. The authors thus investigated the cardiovascular and metabolic effects of an adapted sodium bicarbonate therapy, including prevention of carbon dioxide increase with hyperventilation and ionized calcium decrease with calcium administration.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n Lactic acidosis was induced by hemorrhagic shock. Twenty animals were randomized into five groups: (1) standard resuscitation with blood retransfusion and norepinephrine (2) adapted sodium bicarbonate therapy (3) nonadapted sodium bicarbonate therapy (4) standard resuscitation plus calcium administration (5) hyperventilation. Evaluation was focused\n in vivo<\/jats:italic>\n on extracellular pH, on intracellular pH estimated by P\n 31<\/jats:sup>\n nuclear magnetic resonance and on myocardial contractility by conductance catheter. Aortic rings and mesenteric arteries were isolated and mounted in a myograph, after which arterial contractility was measured.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n All animals in the hyperventilation group died prematurely and were not included in the statistical analysis. When compared with sham rats, shock induced extracellular (median, 7.13; interquartile range, [0.10]\n vs<\/jats:italic>\n . 7.30 [0.01];\n P<\/jats:italic>\n = 0.0007) and intracellular acidosis (7.26 [0.18]\n vs.<\/jats:italic>\n 7.05 [0.13];\n P<\/jats:italic>\n = 0.0001), hyperlactatemia (7.30 [0.01]\n vs.<\/jats:italic>\n 7.13 [0.10];\n P<\/jats:italic>\n = 0.0008), depressed myocardial elastance (2.87 [1.31]\n vs.<\/jats:italic>\n 0.5 [0.53] mmHg\/\u03bcl;\n P<\/jats:italic>\n = 0.0001), and vascular hyporesponsiveness to vasoconstrictors. Compared with nonadapted therapy, adapted bicarbonate therapy normalized extracellular pH (7.03 [0.12]\n vs.<\/jats:italic>\n 7.36 [0.04];\n P<\/jats:italic>\n < 0.05), increased intracellular pH to supraphysiological values, improved myocardial elastance (1.68 [0.41]\n vs.<\/jats:italic>\n 0.72 [0.44] mmHg\/\u03bcl;\n P<\/jats:italic>\n < 0.05), and improved aortic and mesenteric vasoreactivity.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n A therapeutic strategy based on alkalinization with sodium bicarbonate along with hyperventilation and calcium administration increases pH and improves cardiovascular function.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/aln.0000000000000077","type":"journal-article","created":{"date-parts":[[2013,11,21]],"date-time":"2013-11-21T04:12:45Z","timestamp":1385007165000},"page":"926-934","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":37,"title":["Efficient Extra- and Intracellular Alkalinization Improves Cardiovascular Functions in Severe Lactic Acidosis Induced by Hemorrhagic Shock"],"prefix":"10.1097","volume":"120","author":[{"given":"Antoine","family":"Kimmoun","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Ducrocq","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nacira","family":"Sennoun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khodr","family":"Issa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charl\u00e8ne","family":"Strub","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Marie","family":"Escany\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e9bastien","family":"Leclerc","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Levy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20241219","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1136\/emj.2007.055558","article-title":"Lactic acidosis not hyperlactatemia as a predictor of in hospital mortality in septic emergency patients.","volume":"25","year":"2008","journal-title":"Emerg Med J"},{"key":"R2-20241219","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1111\/j.1469-445X.2000.00353.x","article-title":"Simultaneous monitoring of vascular contractility, intracellular pH and intracellular calcium in isolated rat mesenteric arteries; effects of weak bases.","volume":"85","year":"2000","journal-title":"Exp Physiol"},{"issue":"2 Pt 2","key":"R3-20241219","first-page":"H582","article-title":"Disparate effects of three types of extracellular acidosis on left ventricular function.","volume":"276","year":"1999","journal-title":"Am J Physiol"},{"issue":"6 Pt 1","key":"R4-20241219","first-page":"C967","article-title":"Effects of changes of pH on the contractile function of cardiac muscle.","volume":"258","year":"1990","journal-title":"Am J Physiol"},{"issue":"5 Pt 2","key":"R5-20241219","first-page":"H1481","article-title":"Contractile dysfunction during metabolic acidosis: Role of impaired energy metabolism.","volume":"261","year":"1991","journal-title":"Am J Physiol"},{"key":"R6-20241219","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1093\/jb\/mvh175","article-title":"Differential pH effect on calcium-induced conformational changes of cardiac troponin C complexed with cardiac and fast skeletal isoforms of troponin I and troponin T.","volume":"136","year":"2004","journal-title":"J Biochem"},{"issue":"Pt 3)","key":"R7-20241219","first-page":"661","article-title":"The effect of acidosis on systolic Ca2+ and sarcoplasmic reticulum calcium content in isolated rat ventricular myocytes.","volume":"529","year":"2000","journal-title":"J Physiol"},{"issue":"3 Pt 2","key":"R9-20241219","first-page":"H977","article-title":"Effect of acidosis on Ca2+ uptake and release by sarcoplasmic reticulum of intact rat ventricular myocytes.","volume":"275","year":"1998","journal-title":"Am J Physiol"},{"key":"R10-20241219","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.yjmcc.2003.10.012","article-title":"Phospholamban is required for CaMKII-dependent recovery of Ca transients and SR Ca reuptake during acidosis in cardiac myocytes.","volume":"36","year":"2004","journal-title":"J Mol Cell Cardiol"},{"key":"R11-20241219","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1177\/0267659110398733","article-title":"Acidic buffer or plus cyclosporine A post-conditioning protects isolated rat hearts against ischemia-reperfusion injury.","volume":"26","year":"2011","journal-title":"Perfusion"},{"key":"R12-20241219","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1097\/00003246-200102000-00023","article-title":"Effect of NaHCO3 on cardiac energy metabolism and contractile function during hypoxemia.","volume":"29","year":"2001","journal-title":"Crit Care Med"},{"issue":"18 suppl 3","key":"R13-20241219","first-page":"S729","article-title":"Part 8: Adult advanced cardiovascular life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.","volume":"122","year":"2010","journal-title":"Circulation"},{"key":"R14-20241219","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1007\/s00134-012-2769-8","article-title":"Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock, 2012.","volume":"39","year":"2013","journal-title":"Intensive Care Med"},{"key":"R15-20241219","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1097\/00024382-199403000-00007","article-title":"Effects of sodium bicarbonate on striated muscle metabolism and intracellular pH during endotoxic shock.","volume":"1","year":"1994","journal-title":"Shock"},{"key":"R16-20241219","doi-asserted-by":"crossref","first-page":"276","DOI":"10.7326\/0003-4819-105-2-276","article-title":"Lactic acidosis: The case against bicarbonate therapy.","volume":"105","year":"1986","journal-title":"Ann Intern Med"},{"key":"R17-20241219","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1097\/TA.0b013e3182788fc4","article-title":"Bicarbonate therapy in severely acidotic trauma patients increases mortality.","volume":"74","year":"2013","journal-title":"J Trauma Acute Care Surg"},{"key":"R18-20241219","doi-asserted-by":"crossref","first-page":"492","DOI":"10.7326\/0003-4819-112-7-492","article-title":"Bicarbonate does not improve hemodynamics in critically ill patients who have lactic acidosis. A prospective, controlled clinical study.","volume":"112","year":"1990","journal-title":"Ann Intern Med"},{"key":"R19-20241219","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1097\/MCC.0b013e3283069d5c","article-title":"Is there a role for sodium bicarbonate in treating lactic acidosis from shock?","volume":"14","year":"2008","journal-title":"Curr Opin Crit Care"},{"key":"R20-20241219","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1007\/s00134-006-0118-5","article-title":"High-volume hemofiltration as salvage therapy in severe hyperdynamic septic shock.","volume":"32","year":"2006","journal-title":"Intensive Care Med"},{"key":"R21-20241219","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1097\/ALN.0b013e31824f9669","article-title":"Comparison of equipressor doses of norepinephrine, epinephrine, and phenylephrine on septic myocardial dysfunction.","volume":"116","year":"2012","journal-title":"Anesthesiology"},{"key":"R22-20241219","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1097\/CCM.0b013e318192fe4f","article-title":"Activated protein C improves lipopolysaccharide-induced cardiovascular dysfunction by decreasing tissular inflammation and oxidative stress.","volume":"37","year":"2009","journal-title":"Crit Care Med"},{"key":"R23-20241219","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1164\/ajrccm\/148.2.317","article-title":"Bicarbonate does not increase left ventricular contractility during L-lactic acidemia in pigs.","volume":"148","year":"1993","journal-title":"Am Rev Respir Dis"},{"key":"R24-20241219","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1002\/mrm.1910160306","article-title":"Hemodynamic and hepatic pH responses to sodium bicarbonate and Carbicarb during systemic acidosis.","volume":"16","year":"1990","journal-title":"Magn Reson Med"},{"key":"R25-20241219","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1097\/00003246-198808000-00009","article-title":"Effects of sodium bicarbonate in canine hemorrhagic shock.","volume":"16","year":"1988","journal-title":"Crit Care Med"},{"issue":"5 Pt 2","key":"R26-20241219","first-page":"F630","article-title":"Metabolic effects of sodium bicarbonate in hypoxic lactic acidosis in dogs.","volume":"249","year":"1985","journal-title":"Am J Physiol"},{"key":"R27-20241219","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/0300-9572(88)90015-9","article-title":"Comparison of sodium bicarbonate with dichloroacetate treatment of hyperlactatemia and lactic acidosis in the ischemic rat.","volume":"16","year":"1988","journal-title":"Resuscitation"},{"key":"R28-20241219","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1016\/0026-0495(94)90087-6","article-title":"The effects of sodium bicarbonate and a mixture of sodium bicarbonate and carbonate (\u201cCarbicarb\u201d) on skeletal muscle pH and hemodynamic status in rats with hypovolemic shock.","volume":"43","year":"1994","journal-title":"Metabolism"},{"key":"R29-20241219","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1378\/chest.104.3.913","article-title":"Carbicarb, sodium bicarbonate, and sodium chloride in hypoxic lactic acidosis. Effect on arterial blood gases, lactate concentrations, hemodynamic variables, and myocardial intracellular pH.","volume":"104","year":"1993","journal-title":"Chest"},{"key":"R30-20241219","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/1472-6793-8-15","article-title":"The level of hypotension during hemorrhagic shock is a major determinant of the post-resuscitation systemic inflammatory response: An experimental study.","volume":"8","year":"2008","journal-title":"BMC Physiol"},{"key":"R31-20241219","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.1097\/00003246-199808000-00027","article-title":"Comparison of sodium bicarbonate, Carbicarb, and THAM during cardiopulmonary resuscitation in dogs.","volume":"26","year":"1998","journal-title":"Crit Care Med"},{"key":"R32-20241219","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1097\/01.CCM.0000196205.23674.23","article-title":"Increases in tissue Pco2 during circulatory shock reflect selective decreases in capillary blood flow.","volume":"34","year":"2006","journal-title":"Crit Care Med"},{"key":"R33-20241219","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1007\/s001340051204","article-title":"The increase in CO2 production induced by NaHCO3 depends on blood albumin and hemoglobin concentrations.","volume":"26","year":"2000","journal-title":"Intensive Care Med"},{"key":"R34-20241219","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1097\/00003246-200105000-00032","article-title":"Initial effect of sodium bicarbonate on intracellular pH depends on the extracellular nonbicarbonate buffering capacity.","volume":"29","year":"2001","journal-title":"Crit Care Med"},{"key":"R35-20241219","doi-asserted-by":"crossref","first-page":"2331","DOI":"10.1152\/jappl.1989.67.6.2331","article-title":"Extracorporeal bicarbonate space after bicarbonate or a bicarbonate-carbonate mixture in acidotic dogs.","volume":"67","year":"1989","journal-title":"J Appl Physiol (1985)"},{"issue":"6 Pt 1","key":"R36-20241219","first-page":"817","article-title":"Effects of bicarbonate on arterial and brain intracellular pH in neonatal rabbits recovering from hypoxic lactic acidosis.","volume":"111","year":"1987","journal-title":"J Pediatr"},{"key":"R37-20241219","doi-asserted-by":"crossref","first-page":"1352","DOI":"10.1097\/00003246-199111000-00008","article-title":"Effects of bicarbonate therapy on hemodynamics and tissue oxygenation in patients with lactic acidosis: A prospective, controlled clinical study.","volume":"19","year":"1991","journal-title":"Crit Care Med"},{"key":"R38-20241219","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1007\/BF00374415","article-title":"Carbon dioxide induced vasorelaxation in rat mesenteric small arteries precontracted with noradrenaline is endothelium dependent and mediated by nitric oxide.","volume":"423","year":"1993","journal-title":"Pflugers Arch"},{"key":"R39-20241219","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1097\/CCM.0b013e318265ea64","article-title":"Cardiac output response to norepinephrine in postoperative cardiac surgery patients: Interpretation with venous return and cardiac function curves.","volume":"41","year":"2013","journal-title":"Crit Care Med"},{"key":"R40-20241219","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1113\/expphysiol.2012.064733","article-title":"Advancements in pressure-volume catheter technology\u2014Stress remodelling after infarction.","volume":"98","year":"2013","journal-title":"Exp Physiol"},{"key":"R41-20241219","doi-asserted-by":"crossref","first-page":"R153","DOI":"10.1186\/cc11468","article-title":"Mild metabolic acidosis impairs the \u03b2-adrenergic response in isolated human failing myocardium.","volume":"16","year":"2012","journal-title":"Crit Care"},{"key":"R42-20241219","first-page":"437","article-title":"Vasopressor agents; influence of acidosis on cardiac and vascular responsiveness.","volume":"88","year":"1958","journal-title":"Calif Med"},{"key":"R43-20241219","doi-asserted-by":"crossref","first-page":"837","DOI":"10.3109\/01902148809087848","article-title":"Effect of hydrogen ion concentration on in vitro pulmonary vascular reactivity.","volume":"14","year":"1988","journal-title":"Exp Lung Res"},{"issue":"Pt 2","key":"R44-20241219","first-page":"281","article-title":"The effects of extracellular pH and calcium change on force and intracellular calcium in rat vascular smooth muscle.","volume":"488","year":"1995","journal-title":"J Physiol"},{"key":"R45-20241219","doi-asserted-by":"crossref","first-page":"R755","DOI":"10.1186\/cc3886","article-title":"Early veno-venous haemodiafiltration for sepsis-related multiple organ failure.","volume":"9","year":"2005","journal-title":"Crit Care"}],"container-title":["Anesthesiology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/pubs.asahq.org\/anesthesiology\/article-pdf\/120\/4\/926\/263558\/20140400_0-00028.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/anesthesiology.pubs.asahq.org\/article.aspx?volume=120&page=926","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T10:57:46Z","timestamp":1737543466000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/ALN.0000000000000077"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,4]]},"references-count":44,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2014]]}},"URL":"https:\/\/doi.org\/10.1097\/aln.0000000000000077","relation":{},"ISSN":["0003-3022"],"issn-type":[{"value":"0003-3022","type":"print"}],"subject":[],"published":{"date-parts":[[2014,4]]}}}