Elevated serum bicarbonate is a common observation in acute heart failure (AHF) patients.
In AHF, bicarbonate increased with diuretics but decreased with ultrafiltration.
Bicarbonate change was not associated with clinical signs of decongestion.
Adequate decongestion is a key goal in the treatment of patients with AHF.
Modest increases in bicarbonate should not prompt decrease or cessation of diuresis.