Sodium bicarbonate: Difference between revisions
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**'''OR''' tailor to serial ABGs | **'''OR''' tailor to serial ABGs | ||
=== | ===Severe Metabolic Acidemia (pH<7.1) === | ||
*150 mEq/1000 mL inD5W | *IV drip | ||
**150 mEq/1000 mL inD5W | |||
**May reduce 28 day mortality in patients with severe AKI and decrease need for dialysis <ref>Jaber, S., Paugam, C., Futier, E., Lefrant, J.-Y., Lasocki, S., Lescot, T., … BICAR-ICU Study Group. (2018). 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. The Lancet, 392(10141), 31–40.</ref> | |||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
===Cardiac Arrest=== | ===Cardiac Arrest=== | ||
Revision as of 17:48, 11 August 2018
Administration
- Type: 8.4% is common cardiac administered per
- Dosage Forms: 5% ; 7.5% ; 8.4% ; 4.2% ; 4% ; 325mg ; 150 mEq/1000 mL-D5% ; 150 mEq/1150 mL-D5%
- Routes of Administration: IV
- Common Trade Names: N/A
- Abbreviation: NaHOC3
Adult Dosing
Cardiac Arrest
50 mL (1 amp) IV push for severe acidemia and patient is adequately ventilated
- Frequency[1]:
- 1 mEq/kg IV bolus dose initially (~1-2 amps for average adult)
- 0.5 mEq/kg/dose q10min
- OR tailor to serial ABGs
Severe Metabolic Acidemia (pH<7.1)
- IV drip
- 150 mEq/1000 mL inD5W
- May reduce 28 day mortality in patients with severe AKI and decrease need for dialysis [2]
Pediatric Dosing
Cardiac Arrest
1 mL/kg IV push for severe acidemia and patient is adequately ventilated
Special Populations
- Pregnancy Rating: C
- Lactation risk: Infant risk minimal
Renal Dosing
- Adult:
- Pediatric:
Hepatic Dosing
- Adult:
- Pediatric:
Contraindications
- Allergy to class/drug
- Relative:
- Ongoing chloride loss (vomiting, gastrointestinal suction, with concurrent diuretics that induce hypochloremia)
Adverse Reactions
Serious
- Extravasation- cellulitis, tissue necrosis, ulcer
- Metabolic alkalosis
Common
Pharmacology
- Half-life:
- Metabolism:
- Excretion:
Mechanism of Action
Comments
See Also
References
- ↑ eMedicine. Sodium Bicarbonate. http://reference.medscape.com/drug/sodium-bicarbonate-antidote-343749
- ↑ Jaber, S., Paugam, C., Futier, E., Lefrant, J.-Y., Lasocki, S., Lescot, T., … BICAR-ICU Study Group. (2018). 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. The Lancet, 392(10141), 31–40.