Isotonic sodium bicarbonate

The animal should be bathed with copious amounts of water and a mild soap. Phosgene oxime reacts quickly with tissue and decontamination is not expected to be entirely effective after pain has been produced. Sodium hypochlorite (0.5%) or isotonic sodium bicarbonate can help neutralize phosgene oxime that has not yet reacted with tissue. Bums should be managed with topical silver sulfadiazine and systemic antibiotics as needed (Roberts, 1988). Horses and sheep should receive tetanus prophylaxis. Other species should be vaccinated on a case by case basis. 

A. Decontamination of Mucous Membranes and Eyes. The affected tissues should be flushed immediately with water from the water bottle (canteen). The eyes can be flushed with copious amounts of water, or, if available, isotonic sodium bicarbonate (1.26%) or saline (0.9%). 

F. Chemical inactivation using alkalis is effective, whereas chlorinating is ineffective against phosgene oxide. The eyes should be flushed immediately using water or isotonic sodium bicarbonate solution if available. Physical decontamination of the skin using adsorbent powders, e.g., fullers earth, is advised. 

As a result of the shift, the concentration of carbonic acid in the blood increases, the HCO3 /H2CO3 ratio deCTeases to less than 20 1, and respiratory acidosis sets in. The treatment of respiratory acidosis involves identifying the underlying causes and possibly the intravenous administration of isotonic sodium bicarbonate solution or hemodialysis. 

Figure 6 Bicarbonate response (a decrease in the ocular standing potential in response to bicarbonate) in an bino rabbit. An isotonic sodium bicarbonate solution was intravenously aAninista ed during the time indicatedby a thick horizontal line. EHrect-coupledamplification. No stimulus light.

Sodium bicarbonate found to be more effective than isotonic saline hydration. Some clinicians have questioned this trial s methodology... 

Metabolic acidosis involves a build-up of hydrogen ions in the blood, thus lowering blood pH. Under normal physiological conditions, the kidneys excrete excess hydrogen ions, and release more bicarbonate ions into the bloodstream to buffer the excess acid. However, in renal failure, or in diabetic ketoacidosis, this mechanism either fails, or is unable to compensate to an adequate extent. Hence, metabolic acidosis is usually treated with sodium bicarbonate, either intravenously (1.26% or 8.4% i.v. solution) or orally (typically 1 g three times a day). Sodium bicarbonate 1.26% intravenous solution is isotonic with plasma (and with sodium chloride 0.9%), so may be given in large volumes (1-2 L) by peripheral venous catheter to correct metabolic acidosis and provide fluid replacement at the same time. Sodium bicarbonate 8.4% may only be given by central venous catheter. 

Sodium bicarbonate Buffer agent, isotonicity, pH adjustment, solubilizer, stabilizer iv, im, sc, is, ic, other inj. 

Acute renal insufficiency is a rare complication of the use of jering. In one case there was dysuria, hematuria, vomiting, abdominal pain, and blue urine (69). In two other cases there was bilateral loin pain, fever, nausea, vomiting, oliguria, hematuria, and passage of sandy particles in the urine (70). Blood urea and serum creatinine were markedly raised. With conservative therapy, which included rehydration with isotonic saline and alkahniza-tion of the urine with sodium bicarbonate, the acute renal insufficiency resolved. 

Sodium bicarbonate (8.4%, 5% and 1.25% (isotonic)) has been advocated for the correction of metabolic acidosis in horses (Table 17.7) (Divers 1998, Johnson 1995). However, the cause of the... 

Infusion solutions of levarterenol in isotonic glucose, sodium chloride or sodium bicarbonate were stable at least four hours at room temperature. 211... 

Ringer s solution. Physiologic solution containing 0.650 g sodium chloride, 0.014 g potassium chloride, 0.0129 g calcium chloride, 0.020 g sodium bicarbonate, 0.001 g monosodium phosphate, 0.200 g dextrose in 100 g water. It is isotonic with frog blood serum. 

A 49-year-old woman with diabetes and hypertension took a deliberate overdose of 60 tablets containing metformin 500 mg and about 25 tablets of hydrochlorothiazide/lisinopril 12.5/ 20 mg. She was seen and treated within 1 hour. Her pH was 7.18, bicarbonate 6 mmol/1, lactate 9.6 mmol/1, glucose 32 mmol/1, and creatinine 106 (imol/1. Treatment included isotonic saline, sodium bicarbonate, and insulin but 5 hours later her pH was 6.79 and bicarbonate 8.4 mmol/1. Continuous venovenous hemofiltration was begun. Hypotension was treated with noradrenaline, phenylephrine, and then... 

This isotonic volume expander contains sodium, potassium, chloride, and lactate that approximates the fluid and electrolyte composition of the blood. Ringer s lactate (also known as lactated Ringer s or LR) provides ECF replacement and is most often used in the perioperative setting, and for patients with lower GI fluid losses, burns, or dehydration. The lactate component of LR works as a buffer to increase the pH. Large volumes of LR may cause metabolic alkalosis. Because patients with significant liver disease are unable to metabolize lactate sufficiently, Ringer s lactate administration in this population may lead to accumulation of lactate with iatrogenic lactic acidosis. The lactate is not metabolized to bicarbonate in the presence of liver disease and lactic acid can result. 

Infusion of more than 1 L of isotonic (0.9%) sodium chloride may supply more sodium and chloride than normally found in serum, resulting in hypernatremia this may cause a loss of bicarbonate ions, resulting in an acidifying effect. 

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