When you should give bicarbonate (HCO3) in Diabetic Ketoacidosis (DKA), if at all!

[@aroor1785]

Sir u dnt know how great ur teaching is u saved my life as i started working in an icu for the first time. To accept my internal medicine experience to precede to s3 application i needed a whole year in icu whic i had zero clue and background now actually im loving it so much and considering it to be my subspeciality thanks to god almighty then to you sir, you r really sooo great that words are not enough to thank u ... Sir if i might suggest wish if u add to ur channel some series about actual cases u managed the presentation, the notes the plan of management like we r having actual rotation with u, im sure that will add so much to us all who wish if they ever had the honour to be ur reaidents or registerars

[@TheICUChannel]

no words to thank you for your comments, all I can say is we are sharing what we know and learning together. your idea is noted , how can we implement it and maintain the patients privacy, we will figure out.

[@hasantasmim761]

Sir,make a video in details how we prepare bicarbonate drip and administer,indications,contraindication

[@drtejaspatel7641]

Very well explained... Dr Tejas Patel

[@SAZIZMUSIC]

3:29 Sir here did you mean to say that if bicarbonate is above 8 mmol/L in ABG then no need to give bicarbonate ?

[@chandrahaspatidar3273]

Very well explained and very informative sir. Thanks

[@TheICUChannel]

thanks Chandrahas , hope your question is answered.

[@riyazk837]

Hi sir What if hco3 level 3 mmol and bd is 26.5 mmol with ph 7.1 ? Here ph is above 6.9 but hco3 in abg is low , wat to do these in kinds of situtaions ?

[@udaygaikwad2898]

Sir u can explain in acute strock attack hypoglycemia is the indication, how?

[@jackk2907]

Thnakyou so much sir💐

[@sonydas7370]

Sir also share calculation of dosage of bicarb in acidosis and when to discontinue,what are the thing to keep monitoring.Thanks🙏🏻

[@TheICUChannel]

there is no single formula, all depends on conditions and clinical status.

[@sumati2011]

Sir, how do we manage diabetic KETOSIS ( NO ACIDOSIS ). DO we start insulin infusion similar to DKA or give boluses of insulin

[@ajji555]

Thank you sir 😊🙏

[@TheICUChannel]

Most welcome

[@moiznauman5121]

Thank U Sir

[@suprithable]

Indication of HCO3 1) hyperkalemiac metabolic Acidosis 2) ph

[@TheICUChannel]

Yes, correct (in DKA)

[@AliHamza-bz2oo]

Sir plz make a detail video on dka management especially fluid management,, because I have read everytime different algorithm on Google and boos and confused about it

[@TheICUChannel]

yes very nice suggestion... noted.

[@drshalender5406]

Thanks a lot sir. Kindly let me know if hypovolemic shock precipitating with dka and hyperacidosis could be corrected only by bicarbonate iv compensation. How we can approach it by calcium gluconate infusion if hyperkalemia is present along with high ph with septic shock and poor afterload decompensation in case of HF rEF

[@TheICUChannel]

dear can you ask this on telegram so that I can reply by voice message, difficult to write all in detail. t.me/esbicm

[@faiezfarhan6963]

Very helpful,🥰

[@nsas955]

Thank you. But did you mean giving NaHCO3 in 400 STERILE WATER ? Is it safe to give water which is a hypotonic solution ?

[@TheICUChannel]

Not sterile water , it’s hypotonic saline .

[@rehanahmad7567]

Thanku sirji🖤

[@paediatricspotcases5220]

Sir suppose child with inotrope refractory septic shock with severe tachypnea and on ventilator wd acidosis should we give bicarb?

[@TheICUChannel]

Yes , will would given based on above scenario

[@dishankhan3466]

Thanks sir

[@TheICUChannel]

Welcome

[@ahmadgumman3390]

how about when to give HCo3 in Metabolic acidosis in other causes other than DKA sa Severe sepsis, ESRD with severe hyperK?

[@TheICUChannel]

that's a whole long topic.

[@ahmadgumman3390]

@@TheICUChannel OKAY THANK YOU SIR

[@mahendramaurya2000]

Thanks sir❤

[@TheICUChannel]

Most welcome

[@paediatricspotcases5220]

Ph below 7 Life threatning hyperkalemia Respiratory fatigue Shock with not responsive to fluid

[@cms2168]

Thankyou sir