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treatment_sodium_bicarbonate [2025/04/13 02:24] – [1. Overview] jkohtstreatment_sodium_bicarbonate [2025/04/16 04:26] (current) – [2.2 Salicylate Toxicity] jkohts
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 Sodium bicarbonate (NaHCO₃) is primarily used in toxicology to treat sodium channel blocker toxicity (e.g. TCA toxicity).  Sodium bicarbonate (NaHCO₃) is primarily used in toxicology to treat sodium channel blocker toxicity (e.g. TCA toxicity). 
  
-The patient should then be [[:wikitox:alkalinisation|hyperventilated]].+The patient should then be [[concept_serum_alkalinization|hyperventilated]].
  
  
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     * 💊👶 **Sodium bicarbonate 1-2 mmol/kg IV** (i.e. 1-2 mL/kg of 8.4% NaHCO3), as initial dose, then start infusion.     * 💊👶 **Sodium bicarbonate 1-2 mmol/kg IV** (i.e. 1-2 mL/kg of 8.4% NaHCO3), as initial dose, then start infusion.
     * 💊👶 **Sodium bicarbonate 1.5-2× patient's hourly maintenance fluid requirement (weight-based) IV infusion**, then titrate to goal pH.     * 💊👶 **Sodium bicarbonate 1.5-2× patient's hourly maintenance fluid requirement (weight-based) IV infusion**, then titrate to goal pH.
-  * Maintain normokalemia. 
   * Goals:   * Goals:
     * Serum pH 7.5-7.55.     * Serum pH 7.5-7.55.
     * Urinary pH >7.5.     * Urinary pH >7.5.
     * Urine output 2-3 mL/kg/hr.     * Urine output 2-3 mL/kg/hr.
 +    * Maintain normokalemia.
  
  
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 ===== - Special Populations ===== ===== - Special Populations =====
  
-**Renal impairment:** +**Renal impairment:** Use with caution in patients with severe renal impairment due to the risk of fluid overload and hypernatremia.
- +
-**Hepatic impairment:**+