Question

Medical shock victims suffer a critical deficit of oxygen supply to their tissues. What would be the reason for the intravenous administration of bicarbonate to shock victims?

Answer 1

Shock :

When referred generally, an emotional reaction to a stressful situation is called shock

Medical shock:

This shock occurs when tissues in the body don’t receive enough oxygen and nutrients to allow

the cells to function.

When cells are deprived of oxygen, cells starts to use anaerobic mechanism of energy

formation in which lactic acid is a by-product. This affects the acid-base balance in the blood

and the cells begin to leak toxic chemicals into the bloodstream damaging the blood vessels.

Increase in acid levels in the blood decreases the pH (less than 7.35). This condition is termed

acidosis.

Reason for using sodium bicarbonate in medical shock:

Medical shock causes increase in acid content in the body. Imbalance in the acid-base level

contributes to acidosis. The metabolic effects of acidosis include the following:

? Reduction of ATP synthesis in the cells,

? Increased ionized calcium levels,

? Insulin resistance.

In severe acidemia (pH < 7.1), these effects can result in organ dysfunction, morbidity and Mortality .

The use of sodium bicarbonate helps rapid decrease of acid levels in the body which reduces

the damage caused by the same.

Use of IV sodium bicarbonate in metabolic acidosis, that is, an outcome of medical shock :

Although the use of sodium carbonate for the treatment of metabolic acidosis has been heavily

debated for the past 15 years, it is still considered a standard therapy.

Mechanism of action

NaHCO₃ ? Na ⁺ + HCO₃^-

HCO₃^-+ H⁺? H₂CO₃ (Rapidly neutralized acid?) ? H₂O + CO₂