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Sodium Bicarbonate Drip

Reasons for needing a sodium bicarbonate (bicarb) drip are discussed in excellent posts by Pulm Crit and LITFL. One can be made by mixing the following:

Mixing

  • 1 liter D5W, remove 150 ml from bag
  • 3 ampules of 8.4% NaHCO3 (50 mEq each in 50 ml), inject each into the D5W bag

Indication

  • Mixing the infusion above yields 150 mEq/L at 300 mOsmol, which is slightly higher than serum concentrations.
  • Infuse 1 liter @ 200 ml/hr (urine alkalinization) up 1 L/hr (cardiac arrest with poor pressors response), depending on indication.

Sources

  • https://dailymed.nlm.nih.gov/dailymed/getFile.cfm?setid=cde42e87-0055-459f-934e-bab97d1f6a7b&type=pdf&name=cde42e87-0055-459f-934e-bab97d1f6a7b
  • https://calpoison.org/news/use-sodium-bicarbonate-medical-toxicology

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