Infant Data
Results
INDICATIONS
- Metabolic acidosis: Treatment of normal anion gap metabolic acidosis caused by renal or gastrointestinal losses.
- Cardiac Resuscitation: Sodium bicarbonate is not a recommended therapy in neonatal resuscitation guidelines. After effective ventilation is established in patients with documented metabolic acidosis, sodium bicarbonate may be used.
ADVERSE EFFECTS
Bicarbonate administered during inadequate ventilation increases PCO2, thereby decreasing pH. Rapid infusion of hypertonic solution is linked to intracranial hemorrhage in neonates and infants. Extravasation may cause local tissue necrosis at IV site. Fluid overload, hypocalcemia, hypokalemia, and hypernatremia may occur. Aggressive therapy may result in metabolic alkalosis (associated with muscle twitching, irritability, and tetany).
ADMINISTRATION
Intravenous: Administer slow IV push. Rapid IV administration (10 mL/min) of hypertonic sodium bicarbonate may lead to serious consequences (hypernatremia, a decrease in CSF fluid pressure, and possible intracranial hemorrhage) in neonates and children younger than 2 years. MAX 8 mEq/kg/day. The preferred concentration for slow IV administration in neonates is the 4.2% strength (0.5 mEq/mL). Other recommended pediatric concentrations for infusions are 0.25 mEq/mL and 1 mEq/mL. Do not administer by the endotracheal route.
MONITORING
Monitor ABGs, acid/base status, and serum calcium and potassium.