Thomas S H, Stone C K
Department of Emergency Medicine, East Carolina University School of Medicine, Greenville, NC 27858-4354.
Am J Emerg Med. 1994 Jan;12(1):57-9. doi: 10.1016/0735-6757(94)90200-3.
Sodium bicarbonate is an extremely well-known agent that historically has been used for a variety of medical conditions. Despite the widespread use of oral bicarbonate, little documented toxicity has occurred, and the emergency medicine literature contains no reports of toxicity caused by the ingestion of baking soda. Risks of acute and chronic oral bicarbonate ingestion include metabolic alkalosis, hypernatremia, hypertension, gastric rupture, hyporeninemia, hypokalemia, hypochloremia, intravascular volume depletion, and urinary alkalinization. Abrupt cessation of chronic excessive bicarbonate ingestion may result in hyperkalemia, hypoaldosteronism, volume contraction, and disruption of calcium and phosphorus metabolism. The case of a patient with three hospital admissions in 4 months, all the result of excessive oral intake of bicarbonate for symptomatic relief of dyspepsia is reported. Evaluation and treatment of patients with acute bicarbonate ingestion is discussed.
碳酸氢钠是一种广为人知的药物，历史上曾用于多种医疗状况。尽管口服碳酸氢钠被广泛使用，但鲜有记录在案的毒性发生，并且急救医学文献中没有关于因摄入小苏打而导致毒性的报告。急性和慢性口服碳酸氢钠的风险包括代谢性碱中毒、高钠血症、高血压、胃破裂、低肾素血症、低钾血症、低氯血症、血管内容量耗竭和尿液碱化。长期过量摄入碳酸氢钠后突然停药可能导致高钾血症、低醛固酮血症、容量收缩以及钙和磷代谢紊乱。本文报告了一例患者在4个月内三次入院，均因过量口服碳酸氢钠以缓解消化不良症状所致。文中还讨论了急性摄入碳酸氢钠患者的评估和治疗。
