Serafino Garella, M.D., F.A.C.P.; Clare L. Dana, M.D.; Joseph A. Chazan, M.D., F.A.C.P.
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In the treatment of metabolic acidosis the amount of NaHCO3 needed to produce the desired increment in plasma bicarbonate concentration (HCO3-) is usually calculated assuming an apparent space of distribution of HCO3- approximating 50% of body weight. In most patients the changes in plasma HCO3-are reasonably well correlated with the dose of administered HCO3-, except when there is ongoing excessive acid production, as in patients with lactic acid acidosis. In this case continuing HCO3- titration results in large increases in the apparent space of distribution of HCO3- ("alkali resistance").
Recently we have observed several patients with profound metabolic acidosis (plasma
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Garella S, Dana CL, Chazan JA. Influence of the Severity of Metabolic Acidosis on the Response to Bicarbonate Administration.. Ann Intern Med. 1973;78:828. doi: 10.7326/0003-4819-78-5-828_1
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Published: Ann Intern Med. 1973;78(5):828.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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