Sodium bicarbonate
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Metabolic alkalosis and various other toxicities in an elderly patient: case report A 68-year-old woman developed metabolic alkalosis, hypokalaemia, hypocalcaemia, tachycardia and hypotension following irrigation with sodium bicarbonate. The woman underwent surgery for recurrent pseudomyxoma peritonei, during which 10L of sodium bicarbonate 7% was used to irrigate the intraperitoneal cavity over 45 minutes. Thirty minutes later, blood gas analysis revealed severe metabolic alkalosis (pH 7.708) with concurrent hypokalaemia (1.96 mmol/L) and hypocalcaemia (0.67 mmol/L). Her pH increased further to 7.714, with a base excess of 25.6 mmol/L and a bicarbonate level of 47.7 mmol/L, resulting in sinus tachycardia (HR >130 bpm) and hypotension (systolic BP
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