Ammonium chloride infusion for alkalemia
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Patient weight (Kg)
Patient serum Cl (mmol / mEq/L)
R e s u l t s
NH4Cl (mmol)
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Ammonium chloride infusion for alkalemia

In cases of severe alkalemia with HCO3 >40 mmol/L with chloride loss, Ammonium chloride (NH4Cl) infusion may be indicated.

NH4Cl is hepatically converted to urea and HCl (contraindicated in hepatic failure).

This formula generates how many mmol of NH4Cl to administer (usually ½ of the calculated amount is given, then labs repeated) with the total amount calculated placed in 500-1000 mL of Normal Saline (0.9% Saline) and infused at a rate not exceeding 300 mL/hr.

The formula used for ammonium chloride infusion for alkalemia:

  • NH4Cl (mmol) = 0.2 × weight (kg) × [103 - serum Cl (mmol or mEq/L)]
  • NH4Cl = Ammonium chloride
  • Weight = in kg
  • Serum Cl = Serum chloride in mmol or mEq/L

Reference:

  1. April Hazard Vallerand, Cynthia A. Sanoski, Judith Hopfer Deglin. Davis's Drug Guide for Nurses . FA Davis Company; 2012.
  2. Bustamante EA, Levy H. Severe Alkalemia, Hyponatremia, and Diabetic Ketoacidosis in an Alcoholic Man. Chest 1996;110:273-5