In cardiac arrest, a rapid intravenous dose of one to two 50 mL syringes (44.6 to 100 mEq) may be given initially and continued at a rate of 50 mL (44.6 to 50 mEq) every 5 to 10 minutes if necessary (as indicated by arterial pH and blood gas monitoring) to reverse the acidosis. Caution should be observed in emergencies where very rapid infusion of large quantities of bicarbonate is indicated. Bicarbonate solutions are hypertonic and may produce an undesirable rise in plasma sodium concentration in the process of correcting the metabolic acidosis. In cardiac arrest, however, the risks from acidosis exceed those of hypernatremia.In less urgent forms of metabolic acidosis. Sodium Bicarbonate Injection, USP may be added to other intravenous fluids. The amount of bicarbonate to be given to older children and adults over a four-to- eight-hour period is approximately 2 to 5 mEq/kg of body weight - depending upon the severity of the acidosis as judged by the lowering of total CO2 content blood pH and clinical condition of the patient In metabolic acidosis associated with shock, therapy should be monitored by measuring blood gases, plasma osmolar'rty, arterial blood lactate, hemodynamics and cardiac rhythm. Bicarbonate therapy should always be planned in a stepwise fashion since the degree of response from a given dose is not precisely predictable. Initially an infusion of 2 to 5 mEq/kg body weight over a period of 4 to 8 hours will produce a measurable improvement in the abnormal acid- base status of the blood. The next step of therapy is dependent upon the clinical response of the patient. If severe symptoms have abated, then the frequency of administration and the size of the dose may be reduced.

A. thaliana var. Landsberg erecta (LER) suspension cells were treated with NaHCO3 at a final concentration of 1, 3, or 10 mM. For controls, NaNO3 (NO3 − is a macronutrient in MS media) was added in same concentration to nullify the effect of Na+ during the treatment. Furthermore, as HCO3 − induced significant pH changes of the MS media (pH 5.8), we added 50 mM (for 1 mM and 3 mM HCO3 −) and 100 mM (for 10 mM HCO3 −) MES buffer (pH 5.8) to the MS media, and the pH-stabilized MS media were used for both control and HCO3− treatments. In addition, the buffered MS media were sonicated to remove atmospheric gases prior to addition of HCO3−. Cells were incubated at 25 °C for 0, 5, 15, 30, 60, and 120 min on a shaker, and four replicates (n = 4) were generated for each data point after treatment with HCO3 − (treatment) and control. After treatment, 100 ml cells at a concentration of 3 x 10^6 ml−1 were filtered using filter paper mounted on funnels, quickly blotted dry using Kim wipes and immediately snap-frozen in liquid nitrogen and stored in a − 80 °C freezer until metabolite extraction.