Severe Acidosis and Hyperpotassemia Treated with Sodium Bicarbonate Infusion

Effect of Intravenous Small‐Volume Hypertonic Sodium Bicarbonate, Sodium Chloride, and Glucose Solutions in Decreasing Plasma Potassium Concentration in Hyperkalemic Neonatal Calves with Diarrhea

“…Therefore, results of studies that are based on treatment observations in patients with end‐stage renal disease or an experimental setting where dogs are infused with KCl are unlikely suitable for extrapolation of treatment strategies to neonatal diarrheic calves. Interestingly, there are also studies that documented a potassium‐lowering effect of sodium bicarbonate in acidotic humans 44, 45. As an explanation for the existent discrepancies a recent review article39 discussed that the potassium‐lowering effect of sodium bicarbonate depends on the presence of metabolic acidosis and more importantly on the degree of intracellular acidosis as intracellular Na + entry by Na + –H + exchange and Na + ‐bicarbonate cotransport is greater when intracellular pH and ${\text{HCO}}_3^{-}$ are reduced.…”

Effects of pH on Potassium

“…This may account for the fact that the effect of HCO 3 Ϫ administration to reduce plasma K ϩ has been more striking in patients with preexisting acidosis. 31 Effects of pH and HCO 3 Ϫ on internal K ϩ distribution may be modified by hormonal systems that affect cellular K ϩ uptake and release. For example, net cellular uptake of K ϩ is strongly stimulated by insulin because of increased Na ϩ ,K ϩ -ATPase activity.…”

Review Articles: Nondialytic Management of Hyperkalemia and Pulmonary Edema Among End‐Stage Renal Disease Patients: An Evaluation of the Evidence

“…It has long been believed that there is an inverse relationship between serum potassium and blood pH (38,39). As a result, sodium bicarbonate has been widely recommended as a treatment for hyperkalemia (40,41). In a survey of directors of U.S. nephrology training programs, bicarbonate administration was recommended as initial therapy by 32% of respondents (42).…”