Monday, June 18, 2018

Bicarbonate in Cardiac Arrest

R.E.B.E.LEM - June 15, 2018
"Author’s Conclusions:
“The use of sodium bicarbonate improved acid-base status, but did not improve the rate of ROSC and good neurologic survival. We could not draw a conclusion, but our pilot data could be used to design a larger trial to verify the efficacy of sodium bicarbonate.”
Our Conclusion:
We agree with the authors conclusions. While the use of NaHCO3 improved the surrogate endpoint of acid-base status, there was no patient centered improvement seen in this study.
Potential to Impact Current Practice:
This small pilot study should not change clinical practice. Indiscriminate use of NaHCO3 in cardiac arrest should not be performed. However, providers should continue to use their judgement as to which patients with arrest may benefit from NaHCO3.
Bottom Line:
The use of NaHCO3 does not appear to improve clinically meaningful outcomes. A larger study should be undertaken to further evaluate this clinical question."