CHAPTER 38 BICARBONATE THERAPY IN DKA

Does Bicarbonate Therapy Improve the Management of Severe Diabetic Ketoacidosis?

Viallon A, Zeni F, Lafond P, et al. Crit Care Med. 1999;27(12):2690–2693

BACKGROUND

Diabetic ketoacidosis (DKA) has a high mortality rate. Traditional teaching has recommended the use of sodium bicarbonate for patients with pH <7.0. In acidosis, bicarbonate therapy has some theoretically detrimental effects, including worsened hypokalemia, hypocalcemia, CNS, and intracellular acidosis and tissue hypoxia. The balance between the benefits of bicarbonate therapy and these risks had not been investigated prior to this study.

OBJECTIVES

To assess the efficacy of bicarbonate therapy in adult patients with severe DKA (pH <7.10).

METHODS

Retrospective chart review from January 1991 to December 1996.

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