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Sodium bicarbonate (13C) is a stable isotope-labeled diagnostic agent used primarily as a metabolic tracer in clinical research. By administering the compound intravenously or orally, clinicians can track the recovery of 13CO2 in expired air to determine the bicarbonate correction factor, which is essential for the accurate calculation of substrate oxidation rates (such as glucose or lipid oxidation) via indirect calorimetry. This tracer is particularly valuable in assessing the metabolic status of critically ill patients, such as those with sepsis or septic shock, where CO2 retention and altered metabolic pathways can complicate nutritional and therapeutic management. Unlike radioactive tracers, the carbon-13 isotope is stable and does not emit ionizing radiation, making it suitable for repeated use in human subjects for the determination of CO2 production (VCO2) and retention.
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