R.E.B.E.L EM - November 09, 2020 - By Muhammad Durrani
Paper: Wu KH et al. Effectiveness of Sodium Bicarbonate Administration on Mortality in Cardiac Arrest Patients: A Systematic Review and Meta-analysis. J Emerg Med. 2020. PMID: 32978028
"Clinical Question: In adult patients with non-traumatic cardiac arrest, does the administration of sodium bicarbonate improve return of spontaneous circulation (ROSC) and survival to discharge rates?
Clinical Take Home Point:
In this systematic review and meta-analysis, the use of Sodium Bicarbonate in cardiac arrest was not associated with improvements in the rates of ROSC or Survival to Discharge. The findings need to be interpreted in the context of inadequate number of included studies, poor statistical quality with high heterogeneity, and risk of bias/confounders. This is however, an important study that is attempting to clarify the evidence based nature of a routinely used medication during cardiac arrest, and hopefully will serve as a jumping off point for further research into identifying the role of Sodium Bicarbonate in cardiac arrest with special attention to patient oriented outcomes.
The bottom line is that the scales are being tipped towards refuting the use of sodium bicarbonate in cardiac arrest at this time and this is supported by ACLS guidelines except in special circumstances."