Part 4: Parenteral Additives

14: Sodium Bicarbonate

 

Chapter outlines

Composition
Pharmacological Basis
Indications
Metabolic acidosis
Hyperkalaemia
Cardiac arrest
Tricyclic antidepressant overdose
Contrast-induced AKI
Urinary alkalinization
- Barbiturates poisoning
- Salicylate poisoning
- Tumor lysis syndrome
- Rhabdomyolysis
Adverse Effects and Contraindications
Administration

COMPOSITION

Injection 8.4% Sodium Bicarbonate
Each ml contains:
  1 mEq or 1 mmol of Sodium
  1 mEq or 1 mmol of Bicarbonate
  23.0 mg of Sodium and 61.0 mg of Bicarbonate
  84 mg Sodium Bicarbonate
  Osmolarity 2000 mOsmol/L
Injection 7.5% Sodium Bicarbonate
Each ml contains:
  0.89 mEq or 0.89 mmol of Sodium
  75 mg Sodium Bicarbonate
  Osmolarity 1786 mOsmol/L
Injection 4.2% Sodium Bicarbonate
Each ml contains:
  0.5 mEq or 0.5 mmol of Sodium
  0.5 mEq or 0.5 mmol of Bicarbonate
  42 mg Sodium Bicarbonate
  Osmolarity 1000 mOsmol/L
Electrolyte contents and osmolality of different strengths and volumes of solutions are summarized in Table 14.1. Every 10 ml of 4.2%, 7.5%, and 8.4% of sodium bicarbonate (NaHCO3) solutions contain about 5 mEq, 9 mEq, and 10 mEq of bicarbonate as well as sodium, respectively.
Table 14.1 Sodium bicarbonate solutions: different strengths and composition
Strength 4.2% NaHCO3 7.5% NaHCO3 8.4% NaHCO3
Volume (mL) 1.0 500 1.0 10 25 50 1.0 10 25 50
Sodium (mEq) 0.5 250 0.89 8.9 22.5 44.5 1.0 10 25 50
Bicarbonate (mEq) 0.5 250 0.89 8.9 22.5 44.5 1.0 10 25 50
Osmolality 1000 mOsm/L 1786 mOsm/L 1786 mOsm/L

 

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TABLE OF CONTENTS
Part 1: Physiology
Part 2: Basics of Intravenous Fluids and Solutions
Part 3: Fluid Replacement Strategies
Part 4: Parenteral Additives
Part 5: Hemodynamic Monitoring
Part 6: Electrolyte Disorders
Part 7: Acid-Base Disorders
Part 8: Fluid Therapy in Medical Disorders
Part 9: Fluid Therapy in Surgical Disorders
Part 10: Fluid Therapy in Pediatrics
Part 11: Fluid Therapy in Obstetrics
Part 12: Parenteral Nutrition
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