Which of the following should a specialist recommend for severe metabolic acidosis during lengthy pediatric resuscitation?

Sodium bicarbonate is often recommended in cases of severe metabolic acidosis, particularly during prolonged pediatric resuscitation efforts. The rationale behind this choice lies in its ability to rapidly neutralize excess hydrogen ions in the blood, thereby increasing blood pH and alleviating acidosis. This corrective measure can be crucial in stabilizing a child’s condition during resuscitative efforts, especially when there is evidence of significant metabolic derangement.

In lengthy resuscitations, the accumulation of acids can lead to decreased cardiac output and impaired cellular metabolism. Administering sodium bicarbonate helps to address these metabolic derangements and improve overall hemodynamics. It is important to note that while sodium bicarbonate can be beneficial in correcting severe acidosis, it should be used judiciously and in combination with other resuscitative measures.

The other options—phenobarbital, diazepam, and indomethacin—do not specifically address metabolic acidosis in the context of resuscitation. Phenobarbital and diazepam are anticonvulsants that may be used during seizure activity but are not indicated for acidosis. Indomethacin is a non-steroidal anti-inflammatory drug (NSAID) that has its own specific indications and does not