Sir.—Ekblad and colleagues1 infer from their study that the infusion of sodium acetate corrected acidosis in very-low-birth-weight neonates. However, without controls it might not be valid to make this assumption. It is quite possible that the resolution of metabolic acidosis which they observed might have occurred independent of acetate therapy.
In a study of 62 acidemic neonates, Corbet and co-workers2 demonstrated that the correction of serum pH was not significantly effected by the administration of sodium bicarbonate. Arterial pH at 2, 3½, and 6 hours following birth was similar whether infants were given liberal amounts of bicarbonate or none at all. Corbet et al emphasized the importance of adequate ventilation and control of blood pressure in the correction of acidosis.
The metabolic acidosis commonly observed in preterm infants following birth is due to a number of factors. Efforts to establish adequate ventilation, cardiac output, peripheral perfusion, renal