Alkaline diuresis

The administration of alkalinizing agents is of interest in the treatment of intoxication by certain weak acids ( TableS) including salicylates and barbiturates. If the urine is alkalinized, more of the excreted drug becomes ionized, making it unavailable for tubular reabsorption (ion trapping). Addition of 50 to 100 mmol of sodium bicarbonate per liter of intravenous fluids, administered at a rate sufficient to maintain a urine flow of 2 to 4 ml/kg/h is a reasonable starting point. Monitoring of urine pH (ideally at least 8.0), arterial blood gases (maintain below 7.5), and plasma electrolytes is recommended. Potassium supplementation may be required.

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