A patient with severe malaria develops metabolic acidosis (pH 7.18, lactate 9 mmol/L). Why is sodium bicarbonate NOT routinely recommended?...

Question

A patient with severe malaria develops metabolic acidosis (pH 7.18, lactate 9 mmol/L). Why is sodium bicarbonate NOT routinely recommended?

Accepted Answer

Trials show no benefit; it may worsen intracellular acidosis, cause paradoxical CSF acidosis, and precipitate volume overload; the acidosis corrects when the underlying cause is treated

Answer

It is always effective and should be used

Answer

Sodium bicarbonate is unavailable

Answer

Metabolic acidosis does not occur in malaria

Answer

Only oral bicarbonate works

uk-dtmh MCQ (SBA): Bicarbonate in Malarial Acidosis

A patient with severe malaria develops metabolic acidosis (pH 7.18, lactate 9 mmol/L). Why is sodium bicarbonate NOT routinely recommended?