Indications: chronic acidotic conditions; for severe metabolic acidosis use the IV route; emergency treatment of hyperkalemia.

Contra-indications: respiratory and metabolic alkalosis, hypoventilation, hyper-natraemia and in all situations where supply of sodium is contraindicated like cardiac insufficiency, oedema, hypertension and eclampsia.

Dose: by mouth, 4.8 g daily (57 mmole of Na+ and HCO3).

By IV route; the quantity of sodium bicarbonate injection to be infused is determined by the blood gas values and is calculated according to the following formula:

ml of 8.4% sodium bicarbonate injection = negative base excess x kg body weight x 0.3

Correction of metabolic acidosis should be effected too rapidly It is advisable to start administering only half of the calculated dose and make a continuation of the therapy conditional on further blood gas analysis. Drop rate, approximately 40 drops/minute = 120ml/hour.