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
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: https://doi.org/10.7326/0003-4819-78-5-828_1
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Published: Ann Intern Med. 1973;78(5):828.
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