An intravenous infusion of a solution of sodium bicarbonate - better known as Baking soda - reduces respiratory distress and excessive acidity of body fluids in children with a life-threatening asthma flare-up, according to a report from the Netherlands.

High blood acidity, or acidosis, causes the heart to contract less strongly, reduces the effectiveness of beta-agonist bronchodilators used to treat asthma, and may stimulate rapid, shallow breathing, Dr. Corinne M. P. Buysse and her colleagues point out in the medical journal Chest.

They explain that treatment with sodium bicarbonate has been shown to relieve bronchial spasm and restore the response to bronchodilators. However, doctors have avoided the use of intravenous sodium bicarbonate for fear of increasing levels of carbon dioxide in the blood.

Buysse’s team analyzed data on 73 children with life-threatening asthma admitted to the pediatric intensive care unit of the Erasmus MC-Sophia Children’s Hospital in Rotterdam. Sodium bicarbonate was administered intravenously to patients along with usual care if acidosis set in and the patient remained in respiratory distress.

Seventeen patients were given infusions of sodium bicarbonate, which resulted in a significant decrease in acidity, and 16 patients experienced “prompt” improvements in respiratory disease and level of consciousness.

Blood levels of carbon dioxide actually decreased significantly.

The researchers note that sodium bicarbonate was given to 14 patients in a last-ditch attempt to avoid putting them on a respirator, and only one of these subsequently required ventilation. All the patients survived.

“We believe that sodium bicarbonate might be useful as an adjunctive treatment in patients with life-threatening asthma and acidosis in whom mechanical ventilation is considered,” Buysse and her associates conclude.

SOURCE: Chest, March 2005.