DKA sodium bicarbonate NaHCO3 @ 急診小醫師 | 合法藥品大搜索

ROSEN關於DKA部分.page1634裡面說.sodiumbicarbonate不建議泡在normalsaline內使用.因為滲透壓太高pH<7.1每公斤給1mEq.一支NaHCO3約17mEq.

ROSEN關於 DKA部分. page 1634 裡面說. sodium bicarbonate 不建議泡在 normal saline 內使用. 因為滲透壓太高

pH < 7.1 每公斤給 1mEq. 一支NaHCO3 約 17 mEq. 成人一次可以補 3-4 支

不建議例行補充. 很多醫師甚至 pH 6.7 以上都建議不要給. 

治療目標. 將 pH 校正到 7.1 即可. 讓 HCO3 上升 10 mEq/L

使用方式. 將 NaHCO3 泡在 D5W 裡面. 九支泡一公升. 

Many authors question the utility of bicarbonate therapy even in cases of severe acidemia, given these potential harms and the absence of demonstrated benefit.13 However, although evidence is lacking, it is commonly recommended to treat serum pH less than 7.1 empirically with sodium bicarbonate, 1 mEq/kg, unless the underlying acidosis is thought to be quickly responsive to therapy.14 Many experts will not treat pH above 6.7, however, especially in diabetic ketoacidosis, in which profound acidemia is usually well tolerated while the underl...