Sodium Bicarbonate Therapy

Sodium bicarbonate, also known as baking soda, is a white, odorless, crystalline powder which is used on an everyday basis in many households (1). The amphoteric and abrasive properties of the compound allow it to clean surfaces and deodorized effectively without being too chemically harmful. Some common household uses of sodium bicarbonate include fridge deodorizer, whitening toothpaste, and as a substitute other harsh chemical cleaning agents (2). It is also responsible for the rise in flour during baking because of the production of carbon dioxide (2).

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Although many people know sodium bicarbonate as baking soda and about its regular uses, its medical uses are not as well known. Sodium bicarbonate is used as a treatment for metabolic or lactic acidosis. Metabolic acidosis is a condition which occurs when there is too much acid being produced by the body or when the kidneys are not effectively removing enough acid to keep the appropriate pH balance (3). Lactic acidosis, on the other hand, is when there is a buildup of lactic acid in the bloodstream and is most often produced when oxygen levels drop (3). Treating metabolic acidosis with sodium bicarbonate has been a controversial area due to the belief that its treatment may be more harmful than beneficial. One of the main reasons to the controversy is that the removal or ventilation of the carbon dioxide produced needs to be removed in a more efficient manner (3). In addition, it is also believed that the sodium bicarbonate therapy is not controversial itself, but the controversy arises when the severity of the acidosis is not property diagnosed (3). Some aspects of the condition that should be evaluated more thoroughly in order to treat with bicarbonate acid are what are the exact effects of the condition and where it manifested from, is it severe enough to start bicarbonate therapy, how much is the exact calculated amount that should be given, and how much carbon dioxide should would be produced and would it be more beneficial than harmful (3)? After thorough evaluation it is okay to start sodium bicarbonate therapy, however the thought it that many health professionals overlook the evaluation and proceed to therapy (3).

An alternative to sodiumbicarbonate therapy may be with the use of THAM (tromethamine). The difference between these two is that sodium bicarbonate increases PCO₂ (partial pressure of carbon dioxide), whereas THAM may decrease it. Therefore, THAM may be more beneficial for patients with high levels of PCO₂ (4).

References:

1. SODIUM BICARBONATE - PubChem. (n.d.). Retrieved November 18, 2014, from http://pubchem.ncbi.nlm.nih.gov/compound/516892?from=summary#section=Drug-Information
2. Myers, R. (2007). The 100 most important chemical compounds a reference guide. Westport, Conn.: Greenwood Press.
3. Sabatini, S., & Kurtzman, N. (2009). Bicarbonate Therapy in Severe Metabolic Acidosis. Journal of the American Society of Nephrology, 20(4), 692-695.
4. Boyd, J., & Walley, K. (2008). Is there a role for sodium bicarbonate in treating lactic acidosis from shock? Current Opinion in Critical Care, 14, 379-383.

Image Reference:

5.       [Print Photo, Sodium Bicarbonate]. Retrieved from https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjM5XHYkUJ5gaXe8aoOcLqLcTxOtweV5-627zjYf14csgxpQ99rDRPo7QhXCayl_eX2aE6ykqNVZw8dZFxkJO0jxgRMVJPPjVCLm7JsTOUn1M8WS4pmHVsFdbjKMCRFgoJKr4myDPKsuMU/s1600/Baking+Soda+uses.jpg