When do you consider starting a bicarbonate drip for hospitalized patients?
Do you ever initiate this in patients with metabolic acidosis or AKI unrelated to diarrhea? What about in patients with severe lactic acidosis and multi-organ failure, but only modestly decreased pH?
1 Answer
Mednet MemberInvited Expert
Hospital Medicine · Jefferson University Physicians
Answered on
In general, it’s best to follow the serum pH and not the bicarbonate, as there can be respiratory compensation
You should start to worry when the serum bicarbonate is in the range of 10 to 13
• Strongest case for treating: pH ≤7.10 with AKI stage 2–3, especially in shock or sepsis.
• Weaker case: pH b...
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