Lactic Acidosis and Bicarbonate Therapy

Excerpt

To the editor: In his recent letter (1), critical of our support (2) for bicarbonate therapy of keto and lactic acidosis, Hollander straddles the horns of an uncomfortable dilemma. On the one hand, he agrees that acidemia can be lethal, but he decries its correction with bicarbonate. Space limitations precluded our discussing in detail the major shortcomings of published experimental models of lactic acidosis. We maintained that animals undergoing differing degrees of evisceration while receiving cardiotoxins or being rendered acutely and severely hypoxic hardly duplicated commonly occurring human forms of the disorder. The increased cardiac output of the hypoxic model