Evidence supporting the use of: Bicarbonate (mixed)
For the health condition: Dehydration

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Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Bicarbonate (mixed) is scientifically validated for use in the treatment of certain types of dehydration, particularly when associated with metabolic acidosis. When dehydration is severe, especially in settings such as acute diarrhea (e.g., cholera) or diabetic ketoacidosis, significant losses of bicarbonate can occur, leading to a decrease in blood pH (acidosis). In these cases, rehydration solutions—both oral and intravenous—may include sodium bicarbonate or other bicarbonate precursors (such as citrate) to help correct the acid-base disturbance in addition to replacing lost fluids and electrolytes.

Clinical guidelines, including those from the World Health Organization (WHO), recommend the use of oral rehydration solutions (ORS) primarily containing sodium, glucose, potassium, and chloride, but in certain scenarios (e.g., severe acidosis), bicarbonate or citrate is added to the formula. The inclusion of bicarbonate is based on well-established physiological principles and supported by clinical trials demonstrating that correcting acidosis alongside dehydration improves outcomes, especially in pediatric and critical care settings.

However, for most cases of mild to moderate dehydration (such as from mild gastroenteritis), standard ORS without added bicarbonate is sufficient. The addition of bicarbonate is reserved for cases with documented metabolic acidosis. Therefore, the use of bicarbonate in dehydration is evidence-based, but its application is specific to particular clinical contexts rather than all cases of dehydration.

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