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J Korean Soc Neonatol.
November;17(2):155-160.
Published online 2010 November 15 doi: https://doi.org/10.5385/jksn.2010.17.2.155 |
| Copyright ⓒ 2010 The Korean Society of Neonatology
Neonatal Medicine |
| Acid-base Balance and Metabolic Acidosis in Neonates |
| Byong Sop Lee, M.D., Ph.D. |
| Division of Neonatology, Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea |
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Corresponding Author:
Byong Sop Lee, M.D., Ph.D. , Tel: +82-2-3010-3929 , Fax: +82-2-3010-6978 , Email: mdleebs@amc.seoul.kr |
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ABSTRACT |
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| 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: Acid-base imbalance, Metabolic acidosis, Sodium bicarbonate, Premature infant |
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Aims and Scope
