ALiEm - By Andrew Grock, MD | December 4th, 2013
"Intravenous sodium bicarbonate seems like a wonderful drug. It fixes acidosis, pushes potassium into cells, alkalinizes urine, and even helps with smelly feet. However, this literature review of four conditions casts some doubt into the seemingly cure-all that is bicarbonate.
HOW DOES ALL THIS AFFECT MY CLINICAL PRACTICE?
- Do not give bicarbonate during resuscitation codes anymore.
- Bicarbonate on its own does not help in hyperkalemia. It may help insulin+glucose and albuterol work.
- As long as pH >6.9, bicarbonate is not indicated in DKA.
- Bicarbonate in rhabdomyolysis is controversial. The patient needs fluids, fluids, fluids as early as possible."
http://academiclifeinem.com/bicarbonate-completely-useless/
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