Queensland Poisons Information Centre, Queensland Children's Hospital, Brisbane, Queensland, Australia.
Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
Emerg Med Australas. 2022 Aug;34(4):639-641. doi: 10.1111/1742-6723.13995. Epub 2022 Apr 26.
Although sodium bicarbonate can be a life-saving antidote for patients with overdoses resulting in sodium channel blockade, there has been a concerning rise in cases referred to the Poisons Information Centre where inappropriately large doses of bicarbonate have been used resulting in iatrogenic harm. We present a series of three clinical cases where excessive bicarbonate was used to treat poisonings and discuss our approach to managing cardiotoxicity secondary to sodium channel blockade. Serial blood gas analysis should be performed when using bicarbonate to ensure pH targets are met and severe alkalaemia, hypernatraemia and hypokalaemia are avoided. We encourage clinicians to contact the Poisons Information Centre (13 11 26) or their local clinical toxicologist when managing patients with life-threatening sodium channel blockade.
虽然碳酸氢钠可以成为治疗因钠通道阻断而导致中毒的患者的救命解毒剂，但毒物信息中心接到的因不恰当地使用大剂量碳酸氢钠而导致医源性伤害的病例数量令人担忧。我们介绍了三例因中毒而过度使用碳酸氢钠的临床病例，并讨论了我们治疗因钠通道阻断而导致的中毒性心脏病的方法。当使用碳酸氢钠时，应进行连续的血气分析，以确保达到 pH 目标，并避免严重的碱血症、高钠血症和低钾血症。我们鼓励临床医生在治疗有生命危险的钠通道阻断的患者时，与毒物信息中心（13 11 26）或当地临床毒理学家联系。
