Which is a primary intervention for lactic acidosis due to sepsis?

• A. Oral bicarbonate
• B. Diuretic therapy
• C. Thrombolytics
• D. Intravenous bicarbonate

Answer: (D)

Lactic acidosis in sepsis comes from impaired tissue perfusion that drives anaerobic metabolism and lactate buildup; the priority is to restore perfusion and treat the underlying infection. When acidemia is severe, intravenous bicarbonate can rapidly buffer hydrogen ions and raise blood pH, making it the appropriate option for urgent correction. Oral bicarbonate wouldn’t provide reliable, rapid relief in this acute setting and can cause unwanted side effects; diuretic therapy and thrombolytics don’t address the lactate-driven acidosis. So, giving intravenous bicarbonate directly targets the acute acidemia component and is favored in severe cases.