Il Bicarbonato di sodio (Sodium Bicarbonate) è un composto chimico, il sale monosodico dell'acido carbonico ed è un componente estremamente versatile ed impiegato in numerosi settori.

Viene anche comunemente chiamato Nahcolite.

Il nome definisce la struttura della molecola:

• Sodio (Na). Il sodio è un metallo alcalino, un gruppo di elementi altamente reattivi che si trovano nel gruppo 1 della tavola periodica. Il sodio è morbido e di colore bianco-argenteo. È altamente reattivo, soprattutto con l'acqua, e si trova comunemente nei sali e nei minerali. Si riferisce agli ioni sodio (Na+) presenti nel composto. Nel bicarbonato di sodio costituisce il 27,37% della massa.
• Idrogeno (H). L'idrogeno è l'elemento più leggero e più abbondante dell'universo. Si trova nel gruppo 1 della tavola periodica ed è un componente dell'acqua, dei composti organici e di molti altri tipi di molecole. Nel bicarbonato di sodio costituisce l'1,20% della massa.
• Carbonio (C). Il carbonio è un non metallo che può legarsi a se stesso e a molti altri elementi, formando quasi dieci milioni di composti conosciuti. È il componente chiave dei composti organici, che costituiscono la base della vita. Nel bicarbonato di sodio costituisce il 14,30% della massa.
• Ossigeno (O). L'ossigeno è un non metallo altamente reattivo e un agente ossidante che forma facilmente composti con la maggior parte degli elementi. È il terzo elemento più abbondante nell'universo. Nel bicarbonato di sodio costituisce il 57,14% della massa.

Il procedimento di sintesi si svolge in diverse fasi:

• Estrazione del minerale di trona. Nella prima fase si estrae il minerale di trona, una forma naturale di sesquicarbonato di sodio.
• Conversione in soda. Il minerale di trona viene riscaldato in un processo noto come calcinazione, che elimina l'anidride carbonica e l'acqua. In questo modo il trona si trasforma in soda (carbonato di sodio).
• Reazione con anidride carbonica e acqua. Il carbonato di sodio viene fatto reagire con anidride carbonica e acqua. Questa reazione produce bicarbonato di sodio e acqua.

A cosa serve e dove si usa

Viene usato :

• per migliorare la lievitazione del pane
• eliminare lo sporco
• eliminare i cattivi odori
• contro le irritazioni della pelle e del cavo orale
• contro il bruciore di stomaco
• per sciogliere il ghiaccio
• nei detergenti come sbiancante

Cosmetica

Agente abrasivo. Contiene particelle abrasive per rimuovere macchie o biofilm che si accumulano sullo strato corneo o sui denti. Bicarbonato di sodio, farina fossile, silice e molti altri hanno proprietà abrasive. Nei prodotti peeling o esfolianti utilizzati in dermatologia o in applicazioni cosmetiche sono contenuti agenti abrasivi in forma di microsfere sintetiche, tuttavia queste microsfere o particelle abrasive non sono biodegradabili e creano inquinamento negli ecosistemi acquatici.

Agente tampone. E' un ingrediente che può portare una soluzione alcalina o acida a un determinato livello di pH e impedirne la modifica, in pratica uno stabilizzatore di pH che può resistere efficacemente all’instabilità ed all'eventuale cambiamento del pH.

Agente deodorante. Quando in formulazioni cosmetiche sono inserite sostanze che emanano un odore sgradevole (tipici esempi sono  il metil mercaptano e l'idrogeno solforato derivati dall'aglio) i deodoranti attenuano o cancellano le esalazioni sgradevoli. Contribuisce a contrastare la formazione di cattivi odori sulle superfici corporee.

Agente per l'igiene orale. Questo ingrediente può essere inserito nella cavità orale di  per migliorare e/o mantenerne l'igiene orale e la salute, per prevenire o migliorare un disturbo dei denti, gengive,  mucosa. Fornisce effetti cosmetici alla cavità orale come protettivo, detergente, deodorante.

Protettivo della pelle. Crea una barriera protettiva sulla pelle per difenderla da sostanze nocive, irritanti, allergeni, agenti patogeni che possono provocare varie condizioni infiammatorie. Questi prodotti possono anche migliorare la barriera cutanea naturale e nella maggior parte dei casi ne occorrono più di uno per raggiungere un risultato efficace.

Medicina

Il bicarbonato di sodio è usato per via orale per trattare l'acidosi metabolica nei pazienti con malattia renale cronica. Lo studio ha rilevato che l'uso di bicarbonato di sodio per via orale al momento dell'inizio della dialisi ha ridotto significativamente la mortalità per tutte le cause nei pazienti sottoposti a terapia dialitica. (Morooka H, Yamamoto J, Tanaka A, Inaguma D, Maruyama S. Relationship between mortality and use of sodium bicarbonate at the time of dialysis initiation: a prospective observational study. BMC Nephrol. 2021 Apr 6;22(1):118. doi: 10.1186/s12882-021-02330-0.)

Il bicarbonato di sodio è utilizzato nei farmaci da banco per alleviare dispepsia,gonfiore, sintomi comuni dopo pranzi abbondanti Tuttavia, in rari casi, è stato associato a dilatazione gastrica acuta.(Han YJ, Roy S, Siau AMPL, Majid A. Binge-eating and sodium bicarbonate: a potent combination for gastric rupture in adults-two case reports and a review of literature. J Eat Disord. 2022 Nov 9;10(1):157. doi: 10.1186/s40337-022-00677-9.)

Per questo composto chimico sono stati selezionati gli studi più rilevanti con una sintesi dei loro contenuti:

  Bicarbonato di sodio studi

• Formula molecolare: NaHCO₃ CHNaO₃
• Peso molecolare: 84.006 g/mol
• CAS: 144-55-8  199723-76-7  151127-72-9  196216-68-9  246180-97-2  172672-17-2  1182403-48-0  276253-15-7
• UNII: 8MDF5V39QO
• EC Number: 205-633-8
• PubChem Substance ID 329824559
• MDL number MFCD00003528
• Beilstein Registry Number 4153970

Sinonimi: 

• Baking soda
• Sodium hydrogencarbonate
• Sodium acid carbonate
• Bicarbonate of soda
• Carbonic acid monosodium salt
• Neut
• Col-evac
• Sel De vichy
• Monosodium carbonate
• Natrium bicarbonicum
• Monosodium hydrogen carbonate
• Sodium hydrocarbonate
• Natron
• Natriumhydrogenkarbonat
• sodiumbicarbonate
• Meylon
• Acidosan

Bibliografia__________________________________________________________________________

Serpa Neto A, Fujii T, El-Khawas K, Udy A, Bellomo R. Sodium bicarbonate therapy for metabolic acidosis in critically ill patients: a survey of Australian and New Zealand intensive care clinicians. Crit Care Resusc. 2020 Sep;22(3):275-280. doi: 10.1016/S1441-2772(23)00397-6. 

Abstract. Objective: To help shape the design of a future double blind placebo-controlled randomised clinical trial of bicarbonate therapy for metabolic acidosis, based on opinions of intensive care clinicians in Australia and New Zealand. Design: An online survey was designed, piloted and distributed electronically to members of the Australian and New Zealand Intensive Care Society Clinical Trials Group (ANZICS CTG) mailing list. The survey sought to collect information about choice of placebo, method of bicarbonate administration, and acid-base monitoring. Main outcome measures: Responses to six questions in the following domains were sought: 1) solution to be used as placebo; 2) method of administration; 3) target of the intervention; 4) timing of arterial blood gases to monitor the intervention; 5) duration of therapy; and 6) rate of bolus therapy (if selected as the best option). Results: One in every eight ANZICS CTG members completed the survey (118/880, 13.4%). Compound sodium lactate was the preferred solution for placebo (54/118, 45.8%), and continuous infusion of bicarbonate (80/118, 67.8%) was the most frequently selected method of administration. A pH > 7.30 was the preferred target (50/118, 42.4%), while monitoring with arterial blood gas analysis every 2 hours until the target is reached and then every 4 hours was the most favoured option (40/118, 33.9%). The preferred duration of therapy was until the target is achieved (53/118, 44.9%). Conclusions: This survey offers important insights into the preferences of Australian and New Zealand clinicians in regards to any future randomised controlled trial of bicarbonate therapy for metabolic acidosis in the critically ill.

Loomba RS, Abdulkarim M, Bronicki RA, Villarreal EG, Flores S. Impact of sodium bicarbonate therapy on hemodynamic parameters in infants: a meta-analysis. J Matern Fetal Neonatal Med. 2022 Jun;35(12):2324-2330. doi: 10.1080/14767058.2020.1786051.

Abstract. Objective: Sodium bicarbonate is a frequently used electrolyte for the acute treatment of metabolic acidosis in critically ill patients. We performed a systematic review and meta-analysis to determine the effect of sodium bicarbonate on hemodynamics, gas exchange and oximetry in critically children. Methods: A systematic review of published manuscripts was conducted to identify studies of children who received sodium bicarbonate as part of the treatment for metabolic acidosis. A meta-analysis was then conducted to determine the impact of sodium bicarbonate on hemodynamics, gas exchange and oximetry. The following parameters were captured: base deficit, heart rate, mean arterial pressure, blood concentration of carbon dioxide, blood concentration of hydrogen ion, and pulse oximetry. Results: A total of six studies with 341 patients were included in the analyses. All included studies were completed in critically ill infants with a mean age of 1.1 months. The mean dose of sodium bicarbonate was 1.7 meq/kg with a mean time of 67 min prior to repeat hemodynamics being collected after sodium bicarbonate administration. Base deficit significantly improved with a decrease of 2.80 (p = .001) and the partial pressure of carbon dioxide significantly decreased by a mean of -1.65 mmHg (p = .010). There was no change in heart rate, blood pressure, pH, partial pressure of oxygen, or saturation by pulse oximetry. Conclusion: Sodium bicarbonate has a statistically significant but not clinically significant impact on partial pressure of carbon dioxide and base deficit 60 min after sodium bicarbonate administration in critically ill infants. There is no difference noted in pH, partial pressure of oxygen, or saturation by pulse oximetry.

Zeiler FA, Sader N, West M, Gillman LM. Sodium Bicarbonate for Control of ICP: A Systematic Review. J Neurosurg Anesthesiol. 2018 Jan;30(1):2-9. doi: 10.1097/ANA.0000000000000373.

Abstract. Objective: Our goal was to perform a systematic review of the literature on the use of intravenous sodium bicarbonate for intracranial pressure (ICP) reduction in patients with neurologic illness. Methods: Data sources: articles from MEDLINE, BIOSIS, EMBASE, Global Health, Scopus, Cochrane Library, the International Clinical Trials Registry Platform (inception to April 2015), reference lists of relevant articles, and gray literature were searched. Data extraction: 2 reviewers independently extracted data including population characteristics and treatment characteristics. The strength of evidence was adjudicated using both the Oxford and Grading of Recommendation Assessment Development and Education methodology. Results: Our search strategy produced a total 559 citations. Three original articles were included in the review. There were 2 prospective studies, 1 randomized control trial and 1 single arm, and 1 retrospective case report.Across all studies there were a total of 19 patients studied, with 31 episodes of elevated ICP being treated. Twenty-one of those episodes were treated with sodium bicarbonate infusion, with the remaining 10 treated with hypertonic saline in a control model. All elevated ICP episodes treated with sodium bicarbonate solution demonstrated a significant drop in ICP, without an elevation of serum partial pressure of carbon dioxide. No significant complications were described. Conclusions: There currently exists Oxford level 4, Grading of Recommendation Assessment Development and Education D evidence to support an ICP reduction effect with intravenous sodium bicarbonate in TBI. No comments on its impact in other neuropathologic states, or on patient outcomes, can be made at this time.

Grgic J, Rodriguez RF, Garofolini A, Saunders B, Bishop DJ, Schoenfeld BJ, Pedisic Z. Effects of Sodium Bicarbonate Supplementation on Muscular Strength and Endurance: A Systematic Review and Meta-analysis. Sports Med. 2020 Jul;50(7):1361-1375. doi: 10.1007/s40279-020-01275-y. 

Abstract. Background: The effects of sodium bicarbonate on muscular strength and muscular endurance are commonly acknowledged as unclear due to the contrasting evidence on the topic. Objective: To conduct a systematic review and meta-analysis of studies exploring the acute effects of sodium bicarbonate supplementation on muscular strength and endurance. Methods: A search for studies was performed using five databases. Meta-analyses of standardized mean differences (SMDs) were performed using a random-effects model to determine the effects of sodium bicarbonate supplementation on muscular strength (assessed by changes in peak force [N], peak torque [N m], or maximum load lifted [kg]) and muscular endurance (assessed by changes in the number of repetitions performed, isokinetic total work, or time to maintain isometric force production). Subgroup meta-analyses were conducted for the muscular endurance of small vs. large muscle groups and muscular strength tested in a rested vs. fatigued state. A random-effects meta-regression analysis was used to explore possible trends in the effects of: (a) timing of sodium bicarbonate ingestion; and (b) acute increase in blood bicarbonate concentration (from baseline to pre-exercise), on muscular endurance and muscular strength. Results: Thirteen studies explored the effects of sodium bicarbonate on muscular endurance and 11 on muscular strength. Sodium bicarbonate supplementation was found to be ergogenic for muscular endurance (SMD = 0.37; 95% confidence interval [CI]: 0.15, 0.59; p = 0.001). The performance-enhancing effects of sodium bicarbonate were significant for both small (SMD = 0.31; 95% CI: 0.04, 0.59; p = 0.025) and large muscle groups (SMD = 0.40; 95% CI: 0.13, 0.66; p = 0.003). Sodium bicarbonate ingestion was not found to enhance muscular strength (SMD = - 0.03; 95% CI: - 0.18, 0.12; p = 0.725). No significant effects were found regardless of whether the testing was carried out in a rested (SMD = 0.02; 95% CI: - 0.09, 0.13; p = 0.694) or fatigued (SMD = - 0.16; 95% CI: - 0.59, 0.28; p = 0.483) state. No significant linear trends in the effects of timing of sodium bicarbonate ingestion or acute increase in blood bicarbonate concentrations on muscular endurance or muscular strength were found. Conclusions: Overall, sodium bicarbonate supplementation acutely improves muscular endurance of small and large muscle groups, but no significant ergogenic effect on muscular strength was found.

Calvo JL, Xu H, Mon-López D, Pareja-Galeano H, Jiménez SL. Effect of sodium bicarbonate contribution on energy metabolism during exercise: a systematic review and meta-analysis. J Int Soc Sports Nutr. 2021 Feb 5;18(1):11. doi: 10.1186/s12970-021-00410-y.

Abstract. Background: The effects of sodium bicarbonate (NaHCO3) on anaerobic and aerobic capacity are commonly acknowledged as unclear due to the contrasting evidence thus, the present study analyzes the contribution of NaHCO3 to energy metabolism during exercise. Methods: Following a search through five databases, 17 studies were found to meet the inclusion criteria. Meta-analyses of standardized mean differences (SMDs) were performed using a random-effects model to determine the effects of NaHCO3 supplementation on energy metabolism. Subgroup meta-analyses were conducted for the anaerobic-based exercise (assessed by changes in pH, bicarbonate ion [HCO3-], base excess [BE] and blood lactate [BLa]) vs. aerobic-based exercise (assessed by changes in oxygen uptake [VO2], carbon dioxide production [VCO2], partial pressure of oxygen [PO2] and partial pressure of carbon dioxide [PCO2]). Results: The meta-analysis indicated that NaHCO3 ingestion improves pH (SMD = 1.38, 95% CI: 0.97 to 1.79, P < 0.001; I2 = 69%), HCO3- (SMD = 1.63, 95% CI: 1.10 to 2.17, P < 0.001; I2 = 80%), BE (SMD = 1.67, 95% CI: 1.16 to 2.19, P < 0.001, I2 = 77%), BLa (SMD = 0.72, 95% CI: 0.34 to 1.11, P < 0.001, I2 = 68%) and PCO2 (SMD = 0.51, 95% CI: 0.13 to 0.90, P = 0.009, I2 = 0%) but there were no differences between VO2, VCO2 and PO2 compared with the placebo condition. Conclusions: This meta-analysis has found that the anaerobic metabolism system (AnMS), especially the glycolytic but not the oxidative system during exercise is affected by ingestion of NaHCO3. The ideal way is to ingest it is in a gelatin capsule in the acute mode and to use a dose of 0.3 g•kg- 1 body mass of NaHCO3 90 min before the exercise in which energy is supplied by the glycolytic system.

Aschner JL, Poland RL. Sodium bicarbonate: basically useless therapy. Pediatrics. 2008 Oct;122(4):831-5. doi: 10.1542/peds.2007-2400.

Abstract. Common clinical practices often are unsupported by experimental evidence. One example is the administration of sodium bicarbonate to neonates. Despite a long history of widespread use, objective evidence that administration of sodium bicarbonate improves outcomes for patients in cardiopulmonary arrest or with metabolic acidosis is lacking. Indeed, there is evidence that this therapy is detrimental. This review examines the history of sodium bicarbonate use in neonatology and the evidence that refutes the clinical practice of administering sodium bicarbonate during cardiopulmonary resuscitation or to treat metabolic acidosis in the NICU.

Jaber S, Paugam C, Futier E, Lefrant JY, Lasocki S, Lescot T, Pottecher J, Demoule A, Ferrandière M, Asehnoune K, Dellamonica J, Velly L, Abback PS, de Jong A, Brunot V, Belafia F, Roquilly A, Chanques G, Muller L, Constantin JM, Bertet H, Klouche K, Molinari N, Jung B; BICAR-ICU Study Group. Sodium bicarbonate therapy for patients with severe metabolic acidaemia in the intensive care unit (BICAR-ICU): a multicentre, open-label, randomised controlled, phase 3 trial. Lancet. 2018 Jul 7;392(10141):31-40. doi: 10.1016/S0140-6736(18)31080-8. Epub 2018 Jun 14. Erratum in: Lancet. 2018 Dec 8;392(10163):2440. doi: 10.1016/S0140-6736(18)33040-X. 

Wardi G, Holgren S, Gupta A, Sobel J, Birch A, Pearce A, Malhotra A, Tainter C. A Review of Bicarbonate Use in Common Clinical Scenarios. J Emerg Med. 2023 Aug;65(2):e71-e80. doi: 10.1016/j.jemermed.2023.04.012. Epub 2023 Apr 21. PMID: 37442665; PMCID: PMC10530341.

Grgic J, Pedisic Z, Saunders B, Artioli GG, Schoenfeld BJ, McKenna MJ, Bishop DJ, Kreider RB, Stout JR, Kalman DS, Arent SM, VanDusseldorp TA, Lopez HL, Ziegenfuss TN, Burke LM, Antonio J, Campbell BI. International Society of Sports Nutrition position stand: sodium bicarbonate and exercise performance. J Int Soc Sports Nutr. 2021 Sep 9;18(1):61. doi: 10.1186/s12970-021-00458-w. PMID: 34503527; PMCID: PMC8427947.