EFFECT OF MOLAR SODIUM LACTATE IN INCREASING CARDIAC RHYTHMICITY

Abstract

• Sodium lactate, in concentrations of one mol per liter of water, can be given by intravenous infusion or by intracardiac injection without toxic effects. In sinus bradycardia a significant acceleration of heart rate follows, and in complete auriculoventricular block and ventricular standstill the effects have in some instances been lifesaving. The action of molar sodium lactate has been studied in 46 human subjects, including 5 healthy volunteers. In the latter, 100 to 200 cc. produced a slight alkalosis lasting one or two hours. During that time the lactate is metabolized, probably being used directly as fuel by the myocardium. It did not raise the blood pressure above normal in any case. It was effective in restoring the heartbeat when given within two minutes after terminal cardiac arrest. Intracardiac injection succeeded in one instance after intravenous injection had failed, and in another instance the lactate was effective after epinephrine and phenylephrine had been ineffective.