Sodium Bicarbonate Injection Guidelines

Patient-Specific Dosing

• For children, the standard dose is 1-2 mEq/kg IV administered slowly 1
• For newborn infants, only use the 0.5 mEq/mL concentration, with dilution of available stock solutions as necessary 1

Treatment of Specific Conditions

• For sodium channel blocker toxicity, a bolus of 50-150 mEq followed by an infusion of 150 mEq/L solution at 1-3 mL/kg/h is recommended 1
• For contrast-induced nephropathy prevention, sodium bicarbonate (154 mEq/L in dextrose and water) can be administered at 3 mL/kg for 1 hour before contrast medium, followed by 1 mL/kg/h for 6 hours after the procedure 2, 3

Monitoring and Adjustment

• Monitor serum bicarbonate levels every 2-4 hours during active bicarbonate infusion therapy 4
• Continue sodium bicarbonate drip until serum bicarbonate reaches ≥22 mmol/L in patients with metabolic acidosis 4

Important Administration Considerations

• Do not mix sodium bicarbonate with vasoactive amines or calcium 1