Sodium (Natrium) Bicarbonate



8,4% sodium bicarbonate for infusion twenty millilitre vial by B.Braun

Warning: Electrolyte balance and kidney function should be controlled carefully once using bicarbonate infusion


Correction of acidosis
Urine alkalization within the case of intoxication with weak organic acids, e. g. barbiturates or acetylsalicylic acid
Urine alkalization so as to enhance the solubility of drug substances that are poorly soluble in neutral or acid medium, e. g. methotrexate, sulphonamides
Urine alkalization within the case of hemolysis


hypernatraemia (high natrium levels)
hypokalaemia (low potassium levels)

Online sodium bicarbonate deficit calculator

Calculation of sodium bicarbonate demand in metabolic acidosis (pubmed)

Some common calculation formulas:

Bicarbonate deficit = 0.2 x body weight (kg) x base deficit (mEq/L). (Ghosh A, Habermann thulium. mayo Clinic general medicine concise Textbook. CRC Press, 2007. p.599:914.)

Kurtz I. Acid-Base Case Studies. 2nd Ed. Trafford publication (2004); 68:150. recommendation:
“Following the acute administration of bicarbonate as a bolus, its result on the general pH are maximal . Over the following hours, the bicarbonate that was originally administered are taken up into cells. additionally, the elevation of systemic pH decreases the compensative ventilatory response. These 2 effects can decrease the general pH from the most price that was obtained directly following the administration of bicarbonate.” Effective volume of distribution of bicarbonate varies with the HCO3- concentration:

[HCO3-])Lean body weight defined as usual IBW equations:
Estimated ideal weight in (kg):
Males: IBW = fifty kilogram + 2.3 kilogram for every inch over five feet.
Females: IBW = 45.5 kg + 2.3 kilogram for every inch over five feet.

Important points:

1] larger degree of metabolic acidosis –> larger will increase in bicarb venereal disease —> Larger amounts of bicarb should be administered.

2] Following admin of bicarb (as a bolus), there’s a time-dependent decrease in blood HCO3- conc. a little of the HCO3- that is at first distributed within the ECF area, after enters the intracellular area.

3] because the blood HCO3- conc will increase, the PCO2 will increase as a results of a decrease in alveolar ventilation.

Koda-Kimble et al:

Replace five hundredth over three to four hours and also the reminder over twenty four hours. Once the pH is 7.2 – 7.25, the blood serum [HCO3-] shouldn’t be increased by over four to eight Eq/L over six to twelve hours to avoid the risks of over-alkalinization (paradoxical CNS acidosis; decreased affinity of haemoglobin for oxygen resulting in tissue hypoxia and lactic acid production; sodium overload; and hypokalemia).

Kollef MH, Bedient TJ, Isakow W, Witt CA. The Washington Manual of critical Care. Lippincott Williams & Wilkins, 2007; p185:583.

“Primary goal in treating metabolic acidosis is reversal of the underlying method. Administration of bicarbonate in controversial , as some clinical parameters may very well worsen… ” “However, partial correction should be thought of within the setting of severe metabolic acidosis(pH

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