What is the role of alkali therapy in lactic acidosis?

Updated: Dec 08, 2020
  • Author: Christie P Thomas, MBBS, FRCP, FASN, FAHA; Chief Editor: Vecihi Batuman, MD, FASN  more...
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The role of alkali therapy is controversial; some authors recommend raising the serum pH to 7.20 when possible. Some evidence suggests, however, that HCO3- therapy produces only a transient increase in the serum HCO3- level and that this can lead to intracellular acidosis and worsening of lactic acidosis. Furthermore, large amounts of NaHCO3 are commonly required, and volume overload and hypernatremia can occur. In such situations, hemodialysis or continuous venovenous hemofiltration can be used to correct the metabolic abnormalities.

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