The cardiovascular effects of hypertonic sodium bicarbonate in conscious dogs: underlying mechanisms of action

1984 ◽  
Vol 62 (3) ◽  
pp. 314-318 ◽  
Author(s):  
Louis Dumont ◽  
Paul Stanley ◽  
Claude Chartrand
Keyword(s):  
Sodium Bicarbonate ◽  
Left Atrium ◽  
Hypertonic Saline ◽  
Peripheral Resistance ◽  
Conscious Dogs ◽  
Right Atrial ◽  
Bolus Administration ◽  
Stroke Work ◽  
Myocardial Depression ◽  
Acid Base

Mechanisms underlying the transient hypotensive effect (central or peripheral) of rapid bolus administration of hypertonic sodium bicarbonate (NaHCO3) were studied in conscious dogs. Thirteen animals equipped with an electromagnetic flow probe positioned around the ascending aorta were utilized. NaHCO3 (18.5 mequiv. of 1786 mosmol/L), hypertonic saline solution having the same sodium concentration as NaHCO3, and mannitol solution with the same osmolarity as NaHCO3, were injected in the right and in the left atrium. Intra-arterial NaHCO3 was tested to assess its direct peripheral vascular effects. Blood ionic as well as acid–base modifications following NaHCO3 were also studied. Our results indicate that right atrial injection of NaHCO3 elicited transient hypotension (−10 to −15 mmHg (1 mmHg = 133.322 Pa)) and myocardial depression as revealed by a significant decrease of stroke volume (−8%), stroke power (−18%), stroke work (−12%), maximum systolic flow (−13%), peak velocity (−13%), and maximum acceleration (−24%). When the solution is injected in the left atrium, myocardial depression is more pronounced suggesting that the coronary bed is the site of action. Hypertonic saline injections indicate that the sodium load plays a role in this decrement of myocardial function while hyperosmolarity per se, as exemplified with mannitol injections, elicits no negative effect. Transient ionic as well as acid–base disturbances are other mechanisms that have to be considered along with coronary vasoconstriction. Decrement in peripheral resistance appears only with right intra-atrial NaHCO3 suggesting that the pulmonary vascular bed is the origin of this reflex.

Reflexes elicited by acute stretch of atrial vs. pulmonary receptors in conscious dogs

1982 ◽  
Vol 242 (6) ◽  
pp. H1065-H1076 ◽  
Author(s):  
H. D. Schultz ◽  
D. C. Fater ◽  
W. D. Sundet ◽  
P. G. Geer ◽  
K. L. Goetz
Keyword(s):  
Renal Function ◽  
Arterial Pressure ◽  
Left Atrium ◽  
Pulmonary Veins ◽  
Main Pulmonary Artery ◽  
Peripheral Resistance ◽  
Atrial Pressure ◽  
Conscious Dogs ◽  
Right Atrial ◽  
Pulmonary Vasculature

We measured hemodynamics and renal function in conscious dogs while partially obstructing blood flow at various sites within the thorax. Inflation of a balloon in the left atrium increased left atrial pressure (LAP) by 9 mmHg and caused a parallel increase in pulmonary arterial pressure (PAP); heart rate, arterial pressure, and total peripheral resistance increased; stroke volume and right atrial pressure decreased; and cardiac output remained unchanged. The increase in LAP was accompanied by a fourfold increase in urine flow and a threefold increase in sodium excretion. Plasma vasopressin (AVP) and renin activity (PRA) decreased. On the other hand, partial occlusion of the pulmonary veins or the main pulmonary artery produced similar increases in PAP without affecting LAP, systemic hemodynamics, renal function, or plasma AVP. Similarly, inflation of a balloon in the right atrium failed to alter renal function, plasma AVP, or PRA. Finally, constriction of the thoracic inferior vena cava decreased LAP and increased PRA. In summary, these data emphasize that inflation of a balloon in the left atrium of the conscious dog produces a composite response consisting of alterations in cardiovascular function, renal function, and circulating hormones. Moreover, our data indicate that the response is mediated by a reflex initiated from receptors located in the left atrium; we detected no evidence that receptors located in the pulmonary vasculature or right heart contribute to this response.

Metabolic Alkalosis Secondary to Baking Soda Treatment of a Diaper Rash

PEDIATRICS ◽  
1981 ◽  
Vol 67 (6) ◽  
pp. 820-822
Author(s):  
Jose Gonzalez ◽  
Ronald J. Hogg
Keyword(s):  
Case Report ◽  
Side Effects ◽  
Sodium Bicarbonate ◽  
Complete Resolution ◽  
Metabolic Alkalosis ◽  
Acid Base ◽  
Prior Application ◽  
Acid Base Disturbance ◽  
Base Disturbance

A 4-month-old infant was seen with hypokalemic metabolic alkalosis that was associated with prior application of liberal amounts of sodium bicarbonate (baking soda) to a diaper rash. After exclusion of other etiologies of the infant's acid-base disturbance, a complete resolution occurred following discontinuation of the baking soda applications. This case report provides a reminder of the significant side effects that may result from the excessive use of a seemingly harmless household substance.

Increased alpha 1-adrenergic vascular sensitivity during development of hypertension in conscious dogs

1993 ◽  
Vol 264 (4) ◽  
pp. H1259-H1268 ◽  
Author(s):  
N. Uemura ◽  
D. E. Vatner ◽  
Y. T. Shen ◽  
J. Wang ◽  
S. F. Vatner
Keyword(s):  
Adrenergic Receptor ◽  
Peripheral Resistance ◽  
Aortic Pressure ◽  
Conscious Dogs ◽  
Aortic Tissue ◽  
Ang Ii ◽  
Receptor Density ◽  
Adrenergic Stimulation ◽  
Before And After ◽  
Vascular Responsiveness

The goal of this study was to determine whether enhanced vascular responsiveness during the development of perinephritic hypertension is selective or nonspecific. The effects of graded infusions of norepinephrine (NE), phenylephrine (PE), angiotensin II (ANG II), and vasopressin (VP) were examined on mean arterial pressure, total peripheral resistance (TPR), and aortic pressure-diameter relationships in conscious dogs. NE increased TPR significantly greater (P < 0.01) in hypertension than normotension, as did PE infusion, whereas ANG II and VP increased TPR similarly before and after hypertension. Analysis of aortic pressure-diameter relationships also demonstrated significant (P < 0.05) shifts in response to NE and PE, but not ANG II and VP, during the development of hypertension. In normotensive dogs, low doses of ANG II infusion also enhanced the vasoconstrictor response not only to NE and PE but also to VP. In contrast to what was observed in hypertension, in the presence of ANG II infusion after ganglionic blockade, enhanced responses to PE and NE were no longer observed. The alpha 1-adrenergic receptor density in membrane preparations from aortic tissue, as determined by [3H]prazosin binding, was higher (P < 0.05) in hypertensive dogs than control dogs. Thus the vascular responsiveness in the aorta and resistance vessels is enhanced to alpha 1-adrenergic stimulation, but not to all vasoconstrictors, during developing perinephritic hypertension. The mechanism appears to involve increased alpha 1-adrenergic receptor density.

scholarly journals A rare and independent association of Right Atrial Myxoma with Immune Thrombocytopenic Purpura

2019 ◽  
Vol 7 (7) ◽  
pp. 2856
Author(s):  
Karthik Raman R. ◽  
Vijay Anand Palanisamy ◽  
Mithun Sundararaja Ravikumar ◽  
Jeswin Moses ◽  
Sivakumar Pandian ◽  
...  
Keyword(s):  
Left Atrium ◽  
Clinical Features ◽  
Immune Thrombocytopenic Purpura ◽  
Atrial Myxoma ◽  
Right Atrial ◽  
Thrombocytopenic Purpura ◽  
Presenting Symptoms ◽  
Right Atrial Myxoma ◽  
Independent Association

Primary tumours of the heart are rare and the most common benign ones are myxomas.  The clinical features are varied and include a myriad of presenting symptoms like embolic, constitutional, cardiac and also symptoms due to obstruction. Right atrial myxomas are very rarely seen when compared with left atrium. Such myxomas independently co existing with Immune Thrombocytopenic Purpura (ITP) is even rarer and we now present one such case in with right atrial myxoma was associated with ITP and was managed surgically. This case emphasises the fact that ITP can co-exist with myxoma and should be borne in mind when treating such patients surgically.

scholarly journals Warm-Up Intensity Does Not Affect the Ergogenic Effect of Sodium Bicarbonate in Adult Men

2021 ◽  
pp. 1-8
Author(s):  
Rebecca L. Jones ◽  
Trent Stellingwerff ◽  
Paul Swinton ◽  
Guilherme Giannini Artioli ◽  
Bryan Saunders ◽  
...  
Keyword(s):  
Sodium Bicarbonate ◽  
Body Mass ◽  
Acid Base ◽  
Double Blind ◽  
Warm Up ◽  
Adult Men ◽  
Low Intensity ◽  
Main Effect ◽  
Work Done ◽  
Blind Trials

This study determined the influence of a high- (HI) versus low-intensity (LI) cycling warm-up on blood acid-base responses and exercise capacity following ingestion of sodium bicarbonate (SB; 0.3 g/kg body mass) or a placebo (PLA; maltodextrin) 3 hr prior to warm-up. Twelve men (21 ± 2 years, 79.2 ± 3.6 kg body mass, and maximum power output [Wmax] 318 ± 36 W) completed a familiarization and four double-blind trials in a counterbalanced order: HI warm-up with SB, HI warm-up with PLA, LI warm-up with SB, and LI warm-up with PLA. LI warm-up was 15 min at 60% Wmax, while the HI warm-up (typical of elites) featured LI followed by 2 × 30 s (3-min break) at Wmax, finishing 30 min prior to a cycling capacity test at 110% Wmax. Blood bicarbonate and lactate were measured throughout. SB supplementation increased blood bicarbonate (+6.4 mmol/L; 95% confidence interval, CI [5.7, 7.1]) prior to greater reductions with HI warm-up (−3.8 mmol/L; 95% CI [−5.8, −1.8]). However, during the 30-min recovery, blood bicarbonate rebounded and increased in all conditions, with concentrations ∼5.3 mmol/L greater with SB supplementation (p < .001). Blood bicarbonate significantly declined during the cycling capacity test at 110%Wmax with greater reductions following SB supplementation (−2.4 mmol/L; 95% CI [−3.8, −0.90]). Aligned with these results, SB supplementation increased total work done during the cycling capacity test at 110% Wmax (+8.5 kJ; 95% CI [3.6, 13.4], ∼19% increase) with no significant main effect of warm-up intensity (+0.0 kJ; 95% CI [−5.0, 5.0]). Collectively, the results demonstrate that SB supplementation can improve HI cycling capacity irrespective of prior warm-up intensity, likely due to blood alkalosis.

Abstract 14268: Responses to Exercise During Right Heart Catheterisation in Pulmonary Hypertension

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Stephanie Wiltshire ◽  
Katherine Kearney ◽  
Karen Brown ◽  
Carolyn Corrigan ◽  
Annette Pidoux ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Statistical Significance ◽  
Peripheral Resistance ◽  
Hemodynamic Response ◽  
Stroke Work ◽  
Hemodynamic Changes ◽  
Right Heart ◽  
Heart Catheterisation ◽  
Right Heart Catheterisation ◽  
Response To Exercise

Background: Hemodynamic changes during exercise at right heart catheterisation (RHC) may be a diagnostic and prognostic tool in pulmonary arterial hypertension (PAH). Method and Results: We retrospectively assessed the hemodynamic response to exercise during RHC of 138 patients with PAH secondary to idiopathic PAH (IPAH), connective tissue disease (CTD) or congenital heart disease (CHD). RHCs were performed at a single centre between 2007 and 2018. A submaximal comfort-based protocol on a reclined bicycle or straight leg raise test (SLRT) was employed. IPAH demonstrated the highest mean pulmonary artery pressure (mPAP) at rest, rising 47% with exercise, but a 66% rise in CO allowed pulmonary vascular resistance (PVR) to fall. Those with CTD demonstrated a 56% rise in mPAP, 70% rise in CO and PVR remained unchanged. In CHD, there was a 46% rise in mPAP, 49% rise in CO and a rise in PVR. Notably, there was a rise in pulmonary artery wedge pressure (PAWP) in all groups, most marked in those with IPAH. Total peripheral resistance (TPR), pulmonary artery compliance (PAC) and pulmonary artery elastance (Ea) changes were variable. TPR marginally decreased in IPAH patients, remained unchanged in those with CTD and increased in CHD. PAC decreased in all groups, with the lowest values observed in those with IPAH. Ea increased in all groups but was most notably higher in those with IPAH. Right ventricular stroke work index (RVSWI) increased in all patients, the lowest values before and after exercise were observed in the CTD cohort. Mean pulmonary artery pulsatility index (PaPi) increased in all groups, although was subtle and didn’t meet statistical significance for those with CTD and CHD. Conclusions: The hemodynamic response to exercise in patients with PAH differs between aetiologies. A rise in PAWP occurred in all groups, with ventricular interdependence a possible explanation. Whether there is a relationship between exercise hemodynamic changes and prognosis remains undetermined.

Left ventricular-arterial coupling in conscious dogs

1991 ◽  
Vol 261 (1) ◽  
pp. H70-H76 ◽  
Author(s):  
W. C. Little ◽  
C. P. Cheng
Keyword(s):  
Stroke Volume ◽  
Systolic Pressure ◽  
Left Ventricular ◽  
Arterial System ◽  
Conscious Dogs ◽  
Stroke Work ◽  
Arterial Elastance ◽  
Inotropic State ◽  
End Diastolic Volume ◽  
Wide Range

We investigated the criteria for the coupling of the left ventricle (LV) and the arterial system to maximize LV stroke work (SW) and the transformation of LV pressure-volume area (PVA) to SW. We studied eight conscious dogs that were instrumented to measure LV pressure and determine LV volume from three ultrasonically determined dimensions. The LV end-systolic pressure (PES)-volume (VES) relation was determined by caval occlusion. Its slope (EES) was compared with the arterial elastance (EA) and determined as PES per stroke volume. At rest, with intact reflexes, EES/EA was 0.96 +/- 0.20 EES/EA was varied over a wide range (0.18-2.59) by the infusion of graded doses of phenylephrine and nitroprusside before and during administration of dobutamine. Maximum LV SW, at constant inotropic state and end-diastolic volume (VED), occurred when EES/EA equaled 0.99 +/- 0.15. At constant VED and contractile state, SW was within 20% of its maximum value when EES/EA was between 0.56 and 2.29. The conversion of LV PVA to SW increased as EES/EA increased. The shape of the observed relations of the SW to EES/EA and SW/PVA to EES/EA was similar to that predicted by the theoretical consideration of LV PES-VES and arterial PES-stroke volume relations. We conclude that the LV and arterial system produce maximum SW at constant VED when EES and EA are equal; however, the relation of SW to EES/EA has a broad plateau. Only when EA greatly exceeds EES does the SW fall substantially. However, the conversion of PVA to SW increases as EES/EA increases. These observations support the utility of analyzing LV-arterial coupling in the pressure-volume plane.

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