Bicarbonate Therapy in Severe Metabolic Acidosis.

@article{citeulike:2963551, abstract = {The utility of bicarbonate administration to patients with severe metabolic acidosis remains controversial. Chronic bicarbonate replacement is obviously indicated for patients who continue to lose bicarbonate in the ambulatory setting, particularly patients with renal tubular acidosis syndromes or diarrhea. In patients with acute lactic acidosis and ketoacidosis, lactate and ketone bodies can be converted back to bicarbonate if the clinical situation improves. For these patients, therapy must be individualized. In general, bicarbonate should be given at an arterial blood pH of </=7.0. The amount given should be what is calculated to bring the pH up to 7.2. The urge to give bicarbonate to a patient with severe acidemia is apt to be all but irresistible. Intervention should be restrained, however, unless the clinical situation clearly suggests benefit. Here we discuss the pros and cons of bicarbonate therapy for patients with severe metabolic acidosis.}, address = {Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas.}, author = {Sabatini, Sandra and Kurtzman, Neil A A. }, citeulike-article-id = {2963551}, doi = {10.1681/ASN.2007121329}, issn = {1533-3450}, journal = {Journal of the American Society of Nephrology : JASN}, keywords = {acid-base, ckd}, month = {March}, posted-at = {2008-07-04 11:04:58}, priority = {2}, title = {Bicarbonate Therapy in Severe Metabolic Acidosis.}, url = {http://dx.doi.org/10.1681/ASN.2007121329}, year = {2008} }

TY - JOUR ID - citeulike:2963551 L3 - citeulike-article-id:2963551 TI - Bicarbonate Therapy in Severe Metabolic Acidosis. JF - Journal of the American Society of Nephrology : JASN AD - Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas. SN - 1533-3450 N2 - The utility of bicarbonate administration to patients with severe metabolic acidosis remains controversial. Chronic bicarbonate replacement is obviously indicated for patients who continue to lose bicarbonate in the ambulatory setting, particularly patients with renal tubular acidosis syndromes or diarrhea. In patients with acute lactic acidosis and ketoacidosis, lactate and ketone bodies can be converted back to bicarbonate if the clinical situation improves. For these patients, therapy must be individualized. In general, bicarbonate should be given at an arterial blood pH of </=7.0. The amount given should be what is calculated to bring the pH up to 7.2. The urge to give bicarbonate to a patient with severe acidemia is apt to be all but irresistible. Intervention should be restrained, however, unless the clinical situation clearly suggests benefit. Here we discuss the pros and cons of bicarbonate therapy for patients with severe metabolic acidosis. KW - acid-base KW - ckd AU - Sabatini, Sandra AU - Kurtzman, Neil A PY - 2008/03/05/ UR - http://dx.doi.org/10.1681/ASN.2007121329 ER -