Sodium bicarbonate for metabolic acidosis

Abstract

Severe metabolic acidemia is associated with poor prognosis. Possible indications of buffering therapy using sodium bicarbonate infusion depend both of the severity of the patient, the plasma pH and the cause of the acidosis. To better apprehend the balance between the risk and the benefit of administering intravenous sodium bicarbonate, one may take into account both the severity of the acidemia (with a threshold of 7.20) and the presence of an acute kidney injury (a moderate to severe acute kidney injury being in favor of administering intravenous sodium bicarbonate). In this review, we discuss the different indications of using intravenous sodium bicarbonate in the critically ill population.