Neonatal Use of Sodium Bicarbonate

Usual dosing

HCO3 needed (mEq) = 0.3 x Wt (kg) x base deficit (mEq/L)
Administer half of calculated dose, and then assess need for remainder

Usual dosage is 1 to 2 mEq/kg IV/IO slowly, with a max concentration of 0.5mEq/ml

Intravenous: Administer slow IV push. Rapid IV administration (10 mL/min) of hypertonic sodium bicarbonate may lead to serious consequences (hypernatremia, a decrease in CSF fluid pressure, and possible intracranial hemorrhage) in neonates and children younger than 2 years. MAX 8 mEq/kg/day The preferred concentration for slow IV administration in neonates is the 4.2% strength (0.5 mEq/mL). Other recommended pediatric concentrations for infusions are 0.25 mEq/mL and 1 mEq/mL.
Do not administer by the endotracheal route
Monitor ABGs, acid/base status, and serum calcium and potassium

Solution Compatibility: D5W, D10W, and NS.

References: Neofax


Pharmacist, CPHQ, CHQO, Quality Coordinator, Chemotherapy Preparation incharge. Graduated pharmacy school in 2009 I stood with my classmates as we recited the “Oath of a Pharmacist” in. There is one particular vow that stood out to me as we recited the Oath and I embrace this vow, “I will apply my knowledge, experience, and skills to the best of my ability to assure optimal outcomes for my patients.” I love being a pharmacist because it allows me to use my knowledge, abilities, and talents to improve patient outcomes in the community hospital in which I am employed as the pharmacy clinical coordinator.

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