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Table 2 Summary of bicarbonate dose administered in case series and studies

From: Bicarbonate in diabetic ketoacidosis - a systematic review

Reference Nature of Study Dose of bicarbonate given (mean) Dose Estimation Timing (range)
   Conc (%) Total (mM) Wt-adj (mM/kg)   
Addis 1964 [29] CS 8.4 413 NR based on calculated dose 150 initial, and rest
       over 1.5 to 12 hr
Kuzemko 1969 [30]P CS 8.4 255 NR based on calculated dose over 3 to 32 hr
Zimmet 1970 [4] CS NR 185 NR based on pH severity within initial 4 hr
      (≈ half of calculated dose)  
Soler 1972 [22]AP PrC 1.0 200 - 400 NR NR NR
Krumlik 1973 [31]P CS 7.5 115 (3.3/kg) to reach pH ≥ 7.2 based on calculated dose half over 30 min,
    144 (3.9/kg) to reach pH ≥ 7.3   rest over 2 hrs
Munk 1974 [16]P PrC NR 130 2.44 NR NR
Assal 1974 [23]AP ReC NR 230 NR half of calculated dose given within initial 4 hr
Keller 1975 [33] CS NR 345 NR based on calculated dose within initial 24 hr
Reddy 1977 [34]P CS ≈ 0.6 NR 2.50 slow infusion till pH > 7.2 over mean of 4.9 hr
Lutterman 1979 [17] ReC 1.4 167 NR standard dose for all within initial 6 hr
Lever 1983 [18] ReC NR 130-135 NR NR majority slow infusion
Hale 1984 [13] RCT 1.3 150 NR standard dose for all over 1 hr
Morris 1986 [14] RCT NR 120 NR titrated to pH, repeated till intermittent dose, over
      pH > 7.15 30 min; 2 hr interval
Gamba 1991 [15] RCT (DB) ≈ 7.5 84 NR titrated to pH, repeated till intermittent dose, over
      pH rise > 0.05 30 min; 2 hr interval
Okuda 1996 [19] PrC NR 200 NR standard dose (50 mmol/hr) over 4 hr
Green 1998 [24]P ReC NR NR 2.08 NR NR
Viallon 1999 [20] ReC 1.4 120 NR as per attending physician over 1 hr
Latif 2002 [21] ReC NR 50 NR standard dose for all NR
  1. CS = case series; PrC = prospective case-control; ReC = retrospective case-control; RCT = randomized controlled trial; DB = double-blind; Conc = concentration; NR = not reported; mM = mmol; Wt-adj = weight-adjusted
  2. Mean values provided separately for two study arms; mean values provided separately for two study centers
  3. PPediatric studies; APmainly adults but including pediatric patients