Severe Metabolic Acidemia in a Patient with Aleukemic Leukemia

Table 2

Explanation of the hospital course management of lactic acidosis.

Date	Management of lactic acidosis	Lactate acid level MMOL/L	CO2 level MEQ/L
day	0.9 % Normal saline	12.3	11
day	Normosol-R	11	11
week	Dextrose 5% + sodium bicarbonate IV		17
week	0.9 % Normal saline + Sodium Bicarbonate and 1st cycle of chemotherapy(Hyper-CVAD ), with Intrathecal Methotrexate		13
week	Few days after cycle of Hyper CVAD with intrathecal Methotrexate	6.3	25
week	0.45 normal saline + Sodium bicarbonate+ 2nd cycle of Hyper CVAD	- -	28
week	4th cycle of Hyper CVAD		24
Discharge	- -	- -	25

Each 100 mL of Normosol-R contains sodium chloride, 526 mg; sodium acetate, 222 mg; sodium gluconate, 502 mg; potassium chloride, 37 mg; and magnesium chloride hexahydrate, 30 mg. Hyper-CVAD: hyper-fractionated chemotherapy of cyclophosphamide, vincristine, doxorubicin, and dexamethasone.