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Chapter Ten : Acid-Base Physiology

Channel Your Enthusiasm

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Bicarbonate Therapy and Reflux Acidosis

There is no good recommendation for the routine and consistent use of bicarbonate therapy in metabolic much less respiratory acidosis. There are some experimental studies making a case for changes in intracellular pH that are not reflected by the changes in PCO2 but I have never seen any kind of clinical evidence to back up that. At this time, cells tend to be closer to 7.1 cells are well compensated to avoid decreases in pH. In dog and rat studies intracellular myocardial brain cells show minimal changes in their baseline pH from 7.1 when the PACO2 is elevated to over 100 millimeters of mercury and serum pH drops to less than 7.0.

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