Sodium Bicarbonate Hyponatremia

Sodium bicarbonate hyponatremia

Specification

Sodium bicarbonate has an alkalizing effect, which may lead to an increase in serum bicarbonate concentration, but for most patients, this will keep serum bicarbonate within a safe range.

Application

Treatment of hyponatremia: When treating hyponatremia, the treatment plan should be determined based on the patient's volume status and the type of hyponatremia (high volume, low volume, or equal volume). For hypovolemic hyponatremia, isotonic saline should be supplemented to ensure circulating blood volume and allow for adequate free water to be excreted through the kidneys. For isovolumic hyponatremia, it is necessary to limit free water intake, treat the underlying disease, administer hypertonic saline in severe cases, and use loop diuretics if necessary.

Sodium bicarbonate as an emergency treatment: When urgent hypertonic therapy is needed, sodium bicarbonate can be used as an option. The osmotic pressure of 8.4% sodium bicarbonate is approximately 2000 mOsm/L, which is equivalent to 5.8% sodium chloride, and can therefore be considered as "6% saline solution". This means that its effect is twice that of the traditional hypertonic agent 3% sodium chloride. For example, if rapid increase in blood sodium levels is required, 8.4% sodium bicarbonate can be used instead of 3% sodium chloride.

Safety of Sodium Bicarbonate: 8.4% Sodium Bicarbonate is a familiar medication and relatively safe. Ideally, medication should be administered through the central vein, but in emergency situations, it is often administered through peripheral veins. Although it was previously believed that sodium bicarbonate would lower potassium levels, the effect of hypertonic sodium bicarbonate on potassium is minimal.

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