Sodium Bicarbonate in Cardiac Arrest

Sodium Bicarbonate Does Not Work in Cardiac Arrest

The Original Kings of County - September 12, 2018 - By Charles

"This article will not attempt to wade into the pathophysiology of acid-base disorders. From reading the nephrology literature, it seems that this topic is more closely akin to theoretical physics than the sturdy biochemistry I learned in college. Researchers can’t even agree on how to define acidosis, much less what causes it or how to measure or name it. Is it just HCO3 and CO2? Were Henderson and Hasselbach wrong, and it’s actually a strong…

Summary:

1. Acidosis itself is likely not as harmful as we think.
2. Sodium bicarbonate therapy works by changing a metabolic acidosis to a respiratory acidosis, so you must be able to ventilate off the extra CO2 to raise the pH.
3. There are several negative effects of sodium bicarbonate therapy, including worsening intracellular acidosis and increased extracellular volume.
4. The literature behind using sodium bicarbonate in undifferentiated cardiac arrest clearly shows it does not work and may even be harmful. The AHA recommends against its routine use. So stop using it."