Who wants a bicarb question?

[gluck]

How does bicarb increase bp during a code? Is it just increasing CO and Why is the effect so short lived (pun or no pun)?

[slcpicu]

Great Discussion! I will add my 2 cents.

Like others posters have said, bicarb in a code situation will help prevent the overwhelming acidosis that comes from decreased to no cardiac output. In most cases, bicarb only fixes the numbers and not the problem. You still must remember to fix the problem of decreased oxygen delivery to tissues and anerobic metabolism. Due to the henderson-hasselbach equation, your pt must have a good respiratory drive to give bicarb or you will end up making their acidosis worse. (coding hopefully=intubated)

As for increasing bp, in a round about way it does happen (as others have stated for a short period of time) ph's less than 7.25 significantly decrease Cardiac output and therefore decrease O2 delivery and increases in lactic acidosis. On most of our caridac pts, we will give bicarb to fix the acidiosis and give some volume to help with O2 delivery. In the mean time we fix the numbers because of the decreasing of cardiac output. Hopefully, that helps some along with everyone elses information

Thanks!!