Which treatment is recommended for patients with metabolic acidosis and a pH below 7.1?

In cases of metabolic acidosis, particularly when the arterial blood pH drops below 7.1, sodium bicarbonate is recommended as a treatment to help correct the acidosis. The primary goal of administering sodium bicarbonate is to neutralize the acidity in the blood, thereby raising the pH towards a more normal range. This is especially important in situations where the acidosis is severe and the patient is at risk of significant complications, including cardiac arrhythmias and respiratory failure.

Sodium bicarbonate acts as a buffer in the bloodstream. When it dissociates, it releases bicarbonate ions that can combine with excess hydrogen ions, which are responsible for the acidic condition. The result is a reduction in the hydrogen ion concentration, leading to an increase in pH towards a safer level.

Other options, while they have their roles in management of various conditions, do not directly address the immediate need to correct severe acidosis. For example, insulin therapy is primarily used in cases of hyperglycemic emergencies such as diabetic ketoacidosis, where it can help correct associated metabolic derangements, but it does not directly counteract acidosis on its own. Lactated Ringer's solution is a balanced crystalloid solution that can help in rehydration and