title: [Acid production and the need for bicarbonate in diabetic acidosis].
abstract: In a study of 54 patients with diabetic keto-acidosis with pH on admission less than or equal to 7.1, the amount of bicarbonate (HCO3-) necessary to correct the acidosis is compared to the amount predicted by the formula HCO3- (MEq) = 0,3 X body weight (kg) KG) X delta base excess (mEq/l). HCO3- requirements vary widely among patients. In addition, whenever HCO3- is given within 1-2 h the requirement may be inferior to the value calculated, whereas with slow HCO3- infusion it can be twice or three times the amount calculated. Variable HCO3- needs among subjects, and increased needs with time, are due to acid production which may exceed 100 mEq/h, especially in young patients. The amount of HCO3- required is determined not only by the severity of acidosis but also by net acid production, which may vary widely. The assessment of acid-base balance during treatment is useful in evaluating the amount of acid produced and hence the precise need for HCO3- replacement.
mesh_terms: D000136:Acid-Base Equilibrium; D000143:Acids / Q000096:biosynthesis*; D001639:Bicarbonates / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D016883:Diabetic Ketoacidosis / Q000188:drug therapy*; D006801:Humans
chemical_list: D000143:Acids; D001639:Bicarbonates
vernacular_title: Production d'acide et besoins en bicarbonate dans l'acidose diabétique.