Sodium Bicarbonate

What is Sodium Bicarbonate

Sodium bicarbonate is a systemic alkalinizing agent. It most often is administered IV in the treatment of metabolic and respiratory acidosis.

Sodium bicarbonate is also used in the acute treatment of hyperkalemia, although it should be kept in mind that this represents palliative treatment for this condition.

Sodium bicarbonate is sometimes used for urinary alkalinization. Despite being a highly effective antacid, sodium bicarbonate is rarely used for the chronic treatment of peptic ulcer disease because it can be absorbed and can affect systemic acid-base balance. Sodium bicarbonate was in use prior to 1938 and approved by the FDA at its inception.

Brand Names

• Alka-Seltzer Heartburn Relief
• Baros
• Neut

Indications & Dosage

• cardiac arrest
• cardiopulmonary resuscitation
• dyspepsia
• hyperkalemia
• metabolic acidosis
• pyrosis (heartburn)
• urinary alkalinization

For the treatment of metabolic acidosis

for metabolic or respiratory acidosis during cardiopulmonary resuscitation (CPR) (cardiac arrest)

NOTE: Sodium bicarbonate is NOT recommended for routine use in cardiac arrest patients. Bicarbonate therapy should be considered during cardiac arrest only after confirmed interventions (i.e. defibrillation, cardiac compression, intubation, ventilation, epinephrine) have been used, unless the patient has known preexisting hyper-kalemia.

Side Effects

• abdominal pain
• flatulence
• hypernatremia
• injection site reaction
• lactic acidosis
• metabolic alkalosis
• peripheral edema
• seizures
• tetany
• tremor

Monitoring Parameters

• arterial blood gases (ABGs)
• serum sodium
• total CO2

Contraindications

• Bartter’s syndrome
• breast-feeding
• children
• Cushing’s syndrome
• heart failure
• hyperaldosteronism
• hypernatremia
• hypocalcemia
• hypokalemia
• infants
• metabolic alkalosis
• neonates
• pregnancy
• renal disease
• respiratory alkalosis

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