eLetters is an online forum for ongoing peer review. To submit an eLetter please go to the article you wish to respond to and click on the link that reads "eLetters: Submit a Response." Submission of eLetters are open to all health care professionals and experts in related fields.

eLetters to:

SPECIAL ARTICLES:
Judy L. Aschner and Ronald L. Poland
Sodium Bicarbonate: Basically Useless Therapy
Pediatrics 2008; 122: 831-835 [Abstract] [Full text] [PDF]
*eLetters: Submit a response to this article

eLetters published:

[Read eLetters] Sodium bicarbonate and permissive acidemia
Shabih Manzar   (29 January 2009)

Sodium bicarbonate and permissive acidemia 29 January 2009
Top
Shabih Manzar,
Neonatologist
Rockford memorial Hospital

Send letter to journal:
Re: Sodium bicarbonate and permissive acidemia

shabihman{at}hotmail.com Shabih Manzar

The article and the references cited clearly indicate that when managing metabolic acidosis primary focus should be directed in treating the underlying cause rather than using NaHCO3. My questions to authors are:

1. Is there any critical pH? 2. How low can we go with pH in neonates with metabolic acidosis without chemical intervention? 3. Is there any concept of permissive acidemial? 4. What are the chemical alternatives to the use of NaHCO3 in treating severe metabolic acidosis? 5. Is there any laboratory substitute for analysing acid-base status other that blood gas analysis (can't rely on extracellular pH and can't measure intracellular pH in clinical practice)

Sincerely,

Shabih Manzar, MD

Conflict of Interest:

None declared