Author

Design

Country

Setting

Sample

Size

Inclusion Criteria

Intervention

Results

LOE

Lokesh

et al

 

2004

 

RCT

India

 

Hospital

 

Intensive Care Unit

55

Asphyxiated neonates continuing to need positive pressure ventilation at 5 min of life

 

No congenital malformations

Bicarbonate Group (n=27)

Given 4ml/kg(1.8 meq./kg sodium bicarbonate over 3-5 minutes

 

Dextrose Group (n=28)

Given 4ml/kg of undiluted 5% dextrose over 3-5 minutes

 

Outcomes

Death or abnormal neurological examination at discharge. Encephalopathy, multi-organ dysfunction, intraventricular haemorrhage (IVH) and arterial pH at 6 h

Death or Abnormal Neurological Examination at discharge

Bicarb group =52%

Dextrose group =54%

(P =0.88)

 

Incidence of Encephalopathy

Bicarp group =74%

Dextrose group =63%

 

Incidence of Cerebral Oedema

Bicarp group =52%

Dextrose group =30%

 

Need for Inotropic Support

Bicarp group = 44%

Dextrose group =29%

 

Mean arterial pH at 6 hrs were similar between the two groups.

 

Survival to Discharge

Bicarb group=18/27(66.7%)

Dextrose group=19/28(68%)

             (P=0.84)

 

Neurologically Abnormal at Discharge

Bicarb group=28% of the survivors

Dextrose group=32% of the survivors

              (P=0.10).

 

 

 

1b

Murki et al

 

2004

 

RCT

India

 

Neonatal Intensive Care Unit

55

Asphyxiated neonates continuing to need positive pressure ventilation at 5 min of life

 

No congenital malformations

Base Group (n=27)

Given 4ml/kg(1.8 meq./kg sodium bicarbonate over 3-5 minutes

 

Dextrose Group (n=28)

Given 4ml/kg of undiluted 5% dextrose over 3-5 minutes

 

Outcomes

Acid-base status at 1,6,12, and 24 hours of life, need for ventilation, duration of respiratory distress, need for inotropes, duration of inotropes, seizures, cerebral edema and encephalopathy

The mean pH, base deficit and PaCO2 were similar at 24 hours of life

 

Mean pH

Base group =7.38 ± 0.15

Control group =7.38 ± 0.07

 

Base Deficit

Base group =4.26 ± 4.60

Control group=5.02 ± 5.76

 

PaCO2

Base group =34.67 ± 15

Control group =32.67 ± 7.83

 

Acidosis at 24 Hours

 Base group =3[12%]

 Control group =7[28%]

 

All p-values>0.05

 

1b