Current Evidence Surrounding the Use of Sodium Bicarbonate in the Critically Ill Patient

AbstractPurpose of ReviewPatients requiring admission to the intensive care unit frequently develop severe metabolic acidosis. Severe and prolonged acidosis has been correlated with worsened outcomes. Despite theoretical benefit of acidosis correction with sodium bicarbonate administration, available evidence has not supported its use in improving clinical outcomes. This review examines evidence surrounding sodium bicarbonate use in select clinical conditions seen in critically ill patients, including shock, diabetic ketoacidosis, tricyclic antidepressant and acetylsalicylic acid toxicity, and sudden cardiac arrest.Recent FindingsIndications for sodium bicarbonate administration in the critically ill patient are few with limited evidence and not recommended for routine use. Specific clinical scenarios in which sodium bicarbonate may be of benefit include tricyclic antidepressant and acetylsalicylic acid toxicity. Routine sodium bicarbonate use in diabetic ketoacidosis, sudden cardiac arrest, shock, and hyperkalemia management is not recommended.SummaryMetabolic acidosis is a common clinical feature among individuals admitted to the intensive care unit. Severe acidosis has been correlated with worsened outcomes. Sodium bicarbonate use for correction of metabolic acidosis has become common practice in the critically ill patient. Despite theoretical benefit of acidosis correction, evidence reviewed has not supported its use in improving clinical outcomes. Further randomized cont...
Source: Current Emergency and Hospital Medicine Reports - Category: Emergency Medicine Source Type: research