Bicarbonate Deficit Calculator

Calculate the total IV sodium bicarbonate dose needed to correct metabolic acidosis.

For educational and clinical reference. Not a substitute for medical judgment. See the medical disclaimer.
Bicarbonate Deficit
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References

  1. Adrogué HJ, Madias NE. Management of life-threatening acid-base disorders. First of two parts. N Engl J Med. 1998;338(1):26-34.
  2. Adrogué HJ, Madias NE. Management of life-threatening acid-base disorders. Second of two parts. N Engl J Med. 1998;338(2):107-111.

How to use

  1. Enter weight, current HCO₃, and target HCO₃.
  2. Deficit (mEq) updates instantly.
  3. Replace gradually, avoiding over-correction.

Frequently asked questions

How is bicarbonate deficit calculated?

Deficit (mEq) = 0.5 × weight (kg) × (target HCO₃ − current HCO₃). The 0.5 factor represents the apparent distribution volume of bicarbonate.

What is the usual target HCO₃?

A common conservative target is 12–15 mEq/L initially (avoid over-correction), then gradually toward normal (22–24 mEq/L) over hours.

When is bicarbonate replacement indicated?

IV sodium bicarbonate is generally considered for severe metabolic acidosis (pH < 7.1 or HCO₃ < 10–12 mEq/L) or specific scenarios (severe hyperkalemia, certain intoxications, severe AKI).

What risks are associated with over-replacement?

Over-correction can cause metabolic alkalosis, hypernatremia, volume overload, hypokalemia, paradoxical intracellular acidosis, and reduced ionized calcium.

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