We think this has broad domain relevance to Bicarbonate Therapy Eligibility in DKA.
Bicarbonate Therapy Eligibility in DKA
pH
Clinical Warning
Bicarbonate therapy remains controversial in DKA. Controlled trials have not shown improved clinical outcomes or more rapid acidosis resolution for pH between 6.9 and 7.1.
Guidelines & Evidence
Verified
Last Review: 2026
When to Use
When to Consider
Severe acidosis with arterial pH < 6.9.
Severe hyperkalaemia where pH-mediated potassium shifts would be beneficial.
Decreased myocardial contractility or life-threatening arrhythmias suspected to be secondary to severe acidaemia.