Indication of Bicarbonate Replacement

Indication of Bicarbonate Replacement:

• Definite use: if pH <7.10/7.20
• Renal Failure
• Hyperkalemia
• Acidosis in diarrhea
• RTA

Bicarbonate Replacement Formula:

HCO3- to be given:Base Deficit✖️Weight/20

(Baseline HCO3-= 24mEq/L)

e.g. If,

• Weight: 60kg
• ABG results are:
  • pH= 7.20
  • PaCO2= 25 
  • HCO3=12 
  • PaO2= 89

HCO3- to be given= (24-12)✖️60/2

= 12✖️60/2

=720/2

=360 mEq/L

Bicarbonates are divided in 3 equal doses:

=360/3

=120mEq/L

Two doses are given with an interval of 12hours, third dose is missed, because it is compensated by body itself.