Question about sodium bicarb IV

[RxBlueDevils]

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I'm having some trouble looking for information about sodium bicarb for IV infusion (infusion rate, fluid base, max. rate of infusion, whether it can be given directly from the bottle). The references I looked at all kind of have different information. GlobalRph doesn't really give any information. Lexi-Comp doesn't have any info. For those who work in the hospital, how do you normally give sodium bicarb IV? What is a good reference or link that can give me the information that I'm looking for?

 

[njac]

This depends what you're giving it for. Base solution, amount per bag, rate will all depend on indication.

 

[Pharmer Tony]

Sodium Bicarb 8.4% can be given as straight drug, no dilution is required. Dilution and how fast depends on the patient's metabolic/physiological (thus blood pH) status.

ex. if the patient is arresting it's given straight drug as rapid IV push to correct the acidosis from lack of oxygen.

If smaller (or constant) corrections are required (ex. from renal failure) bicarb can be administered as a drip. Again, the parameters vary with patient status. Usually 50-150meqs/L at 50-200ml/hr. It may be diluted in a variety of fluids (Straight drug can also be given as a drip.) SWFI, NS, D5, 1/2NS etc, etc. again depending on patient factors.

This sort of talks about it (although rates are explicitly stated.)
http://globalrph.com/sodium_bicarb_dilution.htm

You can also reference the PI. I'm sure micromedex/lexi says something too, but I'm not at work.

 

[psychoandy]

I'm having some trouble looking for information about sodium bicarb for IV infusion (infusion rate, fluid base, max. rate of infusion, whether it can be given directly from the bottle). The references I looked at all kind of have different information. GlobalRph doesn't really give any information. Lexi-Comp doesn't have any info. For those who work in the hospital, how do you normally give sodium bicarb IV? What is a good reference or link that can give me the information that I'm looking for?

Very generally speaking, I've found that most bicarb drips are mixed as 150 mEq of bicarb/L, or in nursing parlance, 3 amps in a liter. For contrast induced nephropathy or hydration for MTX as inidication you can probably pull the trials and use that as a reference.

 

[rph3664]

If it's used in a code situation, it can be pushed as fast as the vein can take it, and if the patient is critically acidotic, it's pushed usually at 3ml/minute.

It's compatible in pretty much every base IV solution except Lactated Ringer's.

 

[dingerx]

I'm having some trouble looking for information about sodium bicarb for IV infusion (infusion rate, fluid base, max. rate of infusion, whether it can be given directly from the bottle). The references I looked at all kind of have different information. GlobalRph doesn't really give any information. Lexi-Comp doesn't have any info. For those who work in the hospital, how do you normally give sodium bicarb IV? What is a good reference or link that can give me the information that I'm looking for?

3 amps in 1000 ml NS rate of 125 ml/hr in non-code situations

 

[Praziquantel86]

3 amps in 1000 ml NS rate of 125 ml/hr in non-code situations

You mean D5?

 

[rph3664]

In my experience, when a doctor orders D5 with 3 amps of bicarb to run at 150ml/hr, the patient is usually moribund.

 

[njac]

You mean D5?

Or sterile water.

Remember that 0.9NS is 154 mEq/L for tonicity.

 

[njac]

In my experience, when a doctor orders D5 with 3 amps of bicarb to run at 150ml/hr, the patient is usually moribund.

And in my experience I've seen this compound used at this rate for anything from urine alkalization to rhabdo etc etc etc

 

[RxBlueDevils]

Thanks for the info, everyone.

Another question: is sodium bicarb contraindicated in patients with hypocalcemia?