Anest. intenziv. Med. 2025;36(3):188-193 | DOI: 10.36290/aim.2025.036

Bicarbonate in year 2025 - indications, contraindications, pitfalls and future perspectivesReview Article

Müller J.^{1, 2, 3}, Raděj J.², Karvunidis T.^{1, 2}, Valešová L.², Horák J.^{1, 2, 3}, Kříž M.^{1, 2}, Huňková E.², Pavlík R.², Matějovič M.^{1, 2, 3}

¹ Jednotka intenzivní péče, I. interní klinika, Lékařská fakulta v Plzni, Univerzita Karlova

² Jednotka intenzivní péče, I. interní klinika, Fakultní nemocnice Plzeň

³ Biomedicínské centrum, Lékařská fakulta v Plzni, Univerzita Karlova

Hydrogencarbonate (bicarbonate) is a physiologically occurring weak anion that is essential for the regulation of acid-base balance. Sodium bicarbonate solutions of various concentrations are commonly used to correct severe metabolic acidosis and hyperkalemia, However, there is a lack of evidence to support the effectiveness of this intervention, Furthemore, the administration of hypertonic sodium-rich solution may be potentially harmful to certain patient groups. Conversely, the role for bicarbonate in a number of less traditional indications remains to be discovered.

Keywords: bicarbonate, acidosis, hyperkalemia, shock, intoxication, hyponatremia, rhabdomyolysis.

Received: April 28, 2025; Revised: July 9, 2025; Accepted: July 31, 2025; Prepublished online: September 23, 2025; Published: September 30, 2025  Show citation