Sodium bicarbonate therapy in DKA…DO NO HARM!!!

Sodium bicarbonate therapy in DKA (or any other acidosis for that matter) is associated with risks that outweigh NO BENEFITS…DO NO HARM!!!

  • Neither a recent systematic review nor the largest single retrospective cohort of severe DKA support routine use of bicarbonate therapy in DKA
  • Bicarbonate is associated with risk of cerebral oedema and prolonged hospitalisation in paediatric DKA

 

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Sodium Bicarbonate Therapy in Patients with Metabolic Acidosis

DID YOU KNOW: “Evidence that significant harmful effects are derived from metabolic acidosis by itself has NOT been provided in human beings”

Sodium Bicarbonate does NOT treat metabolic acidosis (it just gives you numbers that make you happy about yourself while the patient dies) – Death by Sodium Bicarbonate

Please DO NOT give Sodium Bicarbonate – IT’S HARMFUL TO YOUR ACIDOTIC PATIENT – TREAT THE CAUSE

Sodium bicarbonate may increase serum pH, but may worsen rather than improve prognosis.  Other than indications where sodium bicarbonate is the treatment for the acidosis (such as TCA overdose), the treatment for metabolic acidosis is to correct the underlying cause, whatever it may be.