Neonatal Medicine

The Korean Society of Neonatology (대한신생아학회)
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Acid-base Balance and Metabolic Acidosis in Neonates

신생아의 산-염기 균형과 대사성 산증

  • Lee, Byong-Sop (Division of Neonatology, Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center)
  • 이병섭 (울산대학교 의과대학 서울아산병원 신생아과)
  • Published : 2010.11.30
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Abstract

Metabolic acidosis is commonly encountered issues in the management of critically ill neonates and especially of preterm infants during early neonatal days. In extremely premature infants, low glomerular filtration rate and immaturity of renal tubules to produce new bicarbonate causes renal bicarbonate loss. Higher intake of amino acids, relatively greater contribution of protein to the energy metabolism and mineralization process in growing bones are also responsible for higher acid load in premature infant than in adult. Despite widespread use of sodium bicarbonate in the management of severe metabolic acidosis, use of sodium bicarbonate in premature infants should be restricted to a reasonable but unproven exception such as ongoing renal loss. Despite concern about the low pH value (<7.2) which can compromise cellular metabolic function, no treatment guideline has been established regarding the management of metabolic acidosis in premature infants. Appropriately powered randomized controlled trials of base therapy to treat metabolic acidosis in critically ill newborn infants are demanding.

Keywords

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