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Fluid therapy: for acid-base imbalance

ISSN 2398-2950

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  • Generally, it is most important to correct the underlying cause that led to acid-base imbalance.
  • Normal kidneys will correct mild to moderate acid-base imbalance as long as adequate circulating blood volume is restored.


  • pH>7.1  →   infusion of crystalloid solution such as Hartmanns solution will dilute the acidosis and improve renal perfusion.
  • pH<7.1  →   bicarbonate infusion may be given. Total mEq NaHCO3 = 0.3 x body weight (kg) x base deficit. Give half of this calculated amount slowly, then reevaluate.
  • If metabolic acidosis is strongly suspected from the clinical history and signs but blood-gas analysis is unavailable, then 1-2 mEq/kg bicarbonate   Sodium bicarbonate  may be given slowly.
  • Bicarbonate administration can be dangerous if unnecessary or too rapid. Side-effects include:
    • Paradoxical CSF acidosis.
    • Hypokalemia.
    • Overshoot alkalosis.
    • Reduced oxygen supply to tissues.


  • Metabolic alkalosis may be corrected rapidly by ECF expansion with 0.9% NaCl.
  • Administration of chloride encourages renal excretion of bicarbonate.
  • Concurrent hypokalemia Hypokalemia is common and should be corrected by supplementing fluids Blood biochemistry: potassium with KCl.

Further Reading


Refereed papers

Other sources of information

  • Senior F S (1995) Fluid therapy, electrolytes, and acid-base control. In: Textbook of Veterinary Internal Medicine. Eds: S J Ettinger and E C Feldman. Philadelphia: W B Saunders. pp 294-312. ISBN 0 7216 6795 3.