In a TCA and related compounds overdose, what is the pediatric Sodium Bicarb dose?

In cases of TCA (tricyclic antidepressants) and related compounds overdose, the appropriate sodium bicarbonate dose for pediatric patients is 1 mEq/kg administered via IV or IO. This dosing is based on the therapeutic goals of counteracting metabolic acidosis and stabilizing cardiac function, particularly by alleviating the cardiotoxic effects associated with TCA toxicity. The use of sodium bicarbonate is especially important in this context because it can help in shifting the pH balance, which may protect the heart and improve the myocardial contractility that can be impaired during an overdose.

The recommended dose of 1 mEq/kg is specifically designed to be effective while also considering safety in the pediatric population, as they can be more sensitive to the side effects of medications compared to adults. This careful consideration in dosing helps to mitigate the risk of complications that can arise from excessive bicarbonate administration, such as metabolic alkalosis and volume overload. Therefore, this dosing guideline is essential for effective management in pediatric patients experiencing TCA overdose.