sodium amount in sodium bicarb

Editorial Team / Admin · Dec 19, 2016

That should be information included either on the insert in the box or written on the box itself. When in doubt, you can always ask the facility pharmacist.

offlabel · Dec 21, 2016

That's a really good question and one that isn't asked very often.

Short answer to your question is 'no'. So, in each ml of 8.4% NaHCO3, there is 1 meq of sodium which converts to 23 mg/ml. To save you the math, that comes out to 1150 mg of sodium per amp or about 27% of the compound.

So 2 ml/kg of bicarb raises the serum Na by about 2-3 mM. The clinical implications are clear.

zzyzx · Dec 22, 2016

Thanks for your reply.

Since the sodium is not free but bound up with the bicarb, does it have the same effect as if you gave the patient 1150 of sodium only? In other words, would it immediately raise the sodium level, or would it take time for the sodium and the bicarb to come apart?

offlabel · Dec 22, 2016

Thanks for your reply.
Since the sodium is not free but bound up with the bicarb, does it have the same effect as if you gave the patient 1150 of sodium only? In other words, would it immediately raise the sodium level, or would it take time for the sodium and the bicarb to come apart?

The bicarb works because it disassociates immediately with an immediate corresponding bump in serum Na. In those rare cases (I've had a couple) where several amps are being given, following the Na to avoid a moderate to severe hypernatremia is a good idea.