AnandSwaminathan on Instagram: "Should we give pushes of NaHCO3 in severe metabolic acidosis? -In order for NaHCO3 to increase pH, have to increase ventilation + blow off CO2 -Patients w/ severe metabolic acidosis w/ compensatory respiratory alkalosis are maximally ventilating + maximally blowing off CO2 -Intubating unlikely to help as can’t match their ventilation much less exceed it -Pushes of bicarb will worsen acidosis if you’re not increasing ventilation + can create a paradoxical CNS acido
1:20
AnandSwaminathan on Instagram: "Should we give pushes of NaHCO3 in severe metabolic acidosis? -In order for NaHCO3 to increase pH, have to increase ventilation + blow off CO2 -Patients w/ severe metabolic acidosis w/ compensatory respiratory alkalosis are maximally ventilating + maximally blowing off CO2 -Intubating unlikely to help as can’t match their ventilation much less exceed it -Pushes of bicarb will worsen acidosis if you’re not increasing ventilation + can create a paradoxical CNS acido
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