Some cases of carbon dioxide retention are better untreated. 43 Review of past hospital records consistantly shows a CO2 around 70 at discharge. Go to Index. Therapy of Metabolic Acidosis Mild cases of metabolic acidosis are best left alone. Usually no treatment is needed if the pH is above 7.1, and rarely is it needed if the pH is above 7.2, although the patient's level of discomfort and compensating hyperventilation must be considered.
Metabolic acidosis is treated with sodium bicarbonate, given intravenously.
There is considerable question, however, how beneficial acidosis treatment is for certain patients. The increase in pH decreases respiratory drive, which slows the elimination of this extra carbon dioxide. The CO2 diffuses into the cerebrospinal fluid, causing a paradoxical lowing of pH around the brain, with deepening of coma. For the patient in cardiac arrest, raising the pH hasn't been shown to improve the ultimate outcome. And alkalosis caused by too much bicarbonate is positively deadly for the arrest victim.