QUESTION: I follow your AMSA-BIORC HDIVC formulas. I was wondering if you ever add bicarbonate to the formulas? And if not, why not? Does it decrease the effectiveness of IVC?
ANSWER: There are two reasons for Bicarb in oncology, pH and Anti-cancer potential.
pH: I do add Bicarb in peripheral IV’s if the pH is below 6.5
Anti-cancer: You cannot tell if it will actually slow cancer, but Bicarb in an IV may be of use. There are high dose strategies with and without added DMSO – and I’ll not comment on those as that is very specific and requires other compensations for safety.
In an IVC formula (if using the AMSA formulas) you can safely add 50 mL 8.4% Bicarb to any of the formulas. You may need more sterile water to offset the osmolarity (usually 600-900 is tolerated).