Icoi

' ^^ 3 the desired hirarhnnfite mnnentrfitinn ( ' ' 3

tration (1 3 curr), the desired bicarbonate concentration (1 1 - - ■ p0st), and the body weight (in kilograms) as follows:

H+ deficit = 0.4 x weight x (1 ■ curr - ' ■ post)-

HCCh HCTh

After estimating the H+ deficit, 0.1 to 0.2 N HCl is infused at 20 to 50 mEq/h (mmol/h) into a central vein. Arterial pH must be monitored at least hourly and the infusion stopped as soon as clinically feasible. Ammonium chloride and arginine hy-drochloride, agents that result in the formation ofHCl, are not commonly prescribed, as they may lead to significant toxicity. Ammonium chloride may cause accumulation of ammonia leading to encephalopathy while arginine hydrochloride can induce life-threatening hyperkalemia through unclear mechanisms.

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