What medication is used to reverse the trend of metabolic acidosis during a hypermetabolic crisis?

Sodium bicarbonate is utilized to reverse metabolic acidosis, particularly during a hypermetabolic crisis. Metabolic acidosis occurs when there is an excess of acid in the body or a loss of bicarbonate, leading to lowered pH levels in the blood. In hypermetabolic states, such as those experienced during severe infection, trauma, or endocrine emergencies, the body may produce excess acid, exacerbating the condition.

Sodium bicarbonate acts as a buffer; when administered, it dissociates to release bicarbonate ions, which help to neutralize the excess hydrogen ions in the blood, thereby raising the pH back to a more normal level. This corrective action can help manage the severe acidosis that may occur in these critical situations.

Other medications or procedures listed do not specifically address the reversal of metabolic acidosis in this context. Calcium gluconate is more relevant in cases of hypocalcemia or mitigating certain cardiac effects, while atropine is used to manage bradycardia rather than acidosis. Dialysis can remove excess acids from the blood but is not primarily a pharmacological intervention to reverse acidosis. Rather, it is a more invasive procedure usually reserved for cases where metabolic derangements are severe and refractory to medical management.