sodium-acetylsalicylate--sodium-bicarbonate--sodium-citrate-drug-combination and Pneumonia--Aspiration

A commercially available antacid, a mixture of sodium and potassium bicarbonates and citric acid (Alka-Seltzer Effervescent), was evaluated experimentally and clinically for its efficacy in neutralizing 0.1 N HCl and gastric contents. In an in vitro titration study, Alka-Seltzer Effervescent buffered 5-30 times the volume of HCl with a pH between 1.0 and 2.0 to above a pH of 2.5. In an isolated canine pulmonary lobe model, aspiration of the antacid or acid-antacid mixture caused only a mild increase in lobe weight and did not increase intrapulmonary shunting. In the clinical study, when the antacid was given 5-40 min before administration of general anesthesia in a group of patients for emergency surgery, the pH of the gastric contents in each patient was increased to above 4.0. This contrasts with the control group of patients, which showed 50% (P less than 0.05) of the patients were at risk when no antacid was administered. Preoperative administration of Alka-Seltzer effectively increases the pH of the gastric contents in patients undergoing emergency surgery.

Topics: Adolescent; Adult; Aged; Anesthesia, General; Animals; Aspirin; Bicarbonates; Child; Citrates; Dogs; Drug Combinations; Gastric Acid; Gastric Acidity Determination; Humans; In Vitro Techniques; Intraoperative Complications; Middle Aged; Pneumonia, Aspiration; Premedication; Sodium Bicarbonate