Acid-base abnormalities in infants with congenital heart disease.

Information about the frequency, nature, and extent of acidbase abnormalities in infants with congenital heart disease is limited. Gootman et al. (1963) reported four cases with Fallot's tetralogy, pulmonary atresia, transposition of the great vessels, and severe pulmonary stenosis. All were cyanosed at the time of investigation and had a low pH (7.05-7.28) due to base depletion. Rudolph and Danilowicz (1963) reported the case of a 101-month-old infant with pulmonary atresia and ventricular septal defect in a severe cyanotic attack with an arterial pH of 7.08. Conventional treatment did not produce any improvement, whereas an infusion of sodium bicarbonate brought about dramatic improvement in the level of consciousness and the pH rose to 7.38. Talner et al. (1965) reported 20 infants with congenital heart disease in cardiac failure with increased pulmonary blood-flow and/or pulmonary venous hypertension. They demonstrated the existence of raised arterial Pco2 levels in those with failure. Sunico et al. (1960) had previously reported similar findings. In this paper the acid-base abnormalities in a group of 85 infants with congenital heart disease are examined and correlated with the clinical state. The therapeutic implications are discussed.