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1 Department of Pharmacy Practice, National College of Pharmacy, Kozhikode, Kerala, India 2 Assistant Professor, Department of Emergency Medicine, KMCT Medical College, Calicut, Kerala, India 3 AssistantProfessor, Department of Pharmacy Practice, National College of Pharmacy, Kozhikode, Kerala, India * Corresponding Author Reshma Avicot Renny Department of Pharmacy Practice, National College of Pharmacy, Kozhikode, 673602 (Kerala) Abstract Metabolic acidosis is a condition when there is a relative accumulation of plasma anions than the cations, which reduces the plasma pH. Replacement by sodium bicarbonate therapy is useful for the patients with diarrhea or renal tubular acidosis, but there is no definite evidence that sodium bicarbonate administration to the patients with acute metabolic acidosis. Acute metabolic acidosis occurs in conditions like diabetic ketoacidosis, lactic acidosis, septic shock, intraoperative metabolic acidosis. Patients with advanced chronic kidney disease also shows metabolic acidosis due to increased unmeasured anions and hyperchloremia. It’s also a predominant buffer used in dialysis fluids anda load of sodium bicarbonate subjected to patients on maintenance dialysis during the sessions, suffering a transient metabolic alkalosis of variable severity. Side effects associated with sodium bicarbonate therapy include hypokalemia, ionized hypocalcemia, hypercapnia, and QTc interval prolongation. Administration of sodium bicarbonate in sepsis that is subject to ongoing debate.

The Use of Bicarbonate Therapy in Critical Care for Metabolic Acidosis