ArticleCritical care (London, England)2011
Severe metabolic or mixed acidemia on intensive care unit admission: incidence, prognosis and administration of buffer therapy. A prospective, multiple-center study.
Article in Critical care (London, England), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02476253 (Sodium Bicarbonate to Treat Severe Acidosis in the Critically Ill), which is not on this map. Cited by 86 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Sodium Bicarbonate to Treat Severe Acidosis in the Critically Ill : A Multiple Center Randomized Clinical Trial (BICAR-ICU)
Who cites it
86 citing papers in PubMed, 3 syntheses or guidelines pooled it, 186 citations in OpenAlex.
- Sodium bicarbonate therapy in severe metabolic acidemia: an individual patient data meta-analysis of the BICAR-ICU and BICAR-ICU2 trials.Critical care (London, England) · 2026Pooled it
- Surviving Sepsis Campaign International Guidelines for the Management of Sepsis and Septic Shock in Children 2026.Intensive care medicine · 2026Pooled it
- Bicarbonate and Other Buffer Therapies in Acute Metabolic Acidosis: A Systematic Review and Meta-Analysis.Acta anaesthesiologica Scandinavica · 2026Pooled it
- Comparison of two different bicarbonate replacement fluids during CVVH with RCA: a prospective, randomized, controlled trial.Intensive care medicine · 2025Trial
- Additional Bicarbonate Infusion Complements WHO Rehydration Therapy in Children with Acute Diarrhea and Severe Dehydration Presenting with Severe Non-anion Gap Metabolic Acidemia: An Open Label Randomized Trial.Indian journal of pediatrics · 2025Trial
- Development of a novel tool: a nomogram for predicting in-hospital mortality of patients in intensive care unit after percutaneous coronary intervention.BMC anesthesiology · 2023Trial
- Sodium bicarbonate therapy for metabolic acidosis in critically ill patients: a survey of Australian and New Zealand intensive care clinicians.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2020Trial
- Continuous imputation of blood gas and metabolic panel laboratory values in the intensive care unit using machine learning.Journal of clinical monitoring and computing · 2026Article
- Age-related modification of the association between arterial blood pH and intensive care unit mortality: a nationwide retrospective observational study using the Japanese Intensive Care Patient Database (JIPAD).Journal of intensive care · 2026Article
- A hybrid multi-criteria decision-making framework for prioritising clinical determinants of medical futility in the intensive care unit.Journal of intensive care · 2026Article
- The usual suspects: a pragmatic framework to identify and address reversible contributors in apparent refractory septic shock.Critical care (London, England) · 2026Review
- Sodium bicarbonate in critical illness: Correcting acidaemia without changing outcomes?Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2026Article
- Stable bioreactor control reveals acidic pH-driven metabolic reprogramming and mitochondrial dysfunction in human lymphoblastoid cells.Communications biology · 2026Article
- Metabolic acidosis and sodium bicarbonate therapy in critically ill patients: A multinational survey of international and Chinese practitioners.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2026Article
- Article
- Non-occlusive mesenteric ischemia complicated by ischemic hepatitis presenting as severe lactic acidosis: a case report.Frontiers in medicine · 2026Article
- Integrative analysis and imputation of multiple data streams via deep Gaussian processes.Bioinformatics advances · 2026Article
- Predictive Value of 48-hour Anion Gap Fluctuations in ICU Patients with Acute Kidney Injury: An Analysis based on MIMIC Database.Current pharmaceutical design · 2026Article
- Evolutive acid-base derangements in critically ill patients: epidemiological aspects, association with mortality and metabolic acidosis prediction.Critical care science · 2026Article
- Bicarbonate in AKI and acidemia to reduce mortality and need for kidney replacement therapy.Clinical kidney journal · 2026Article
26 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors at 9 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionIn this study, we sought describe the incidence and outcomes of severe metabolic or mixed acidemia in critically ill patients as well as the use of sodium bicarbonate therapy to treat these illnesses.
methodsWe conducted a prospective, observational, multiple-center study. Consecutive patients who presented with severe acidemia, defined herein as plasma pH below 7.20, were screened. The incidence, sodium bicarbonate prescription and outcomes of either metabolic or mixed severe acidemia were analyzed.
resultsAmong 2, 550 critically ill patients, 200 (8%) presented with severe acidemia, and 155 (6% of the total admissions) met the inclusion criteria. Almost all patients needed mechanical ventilation and vasopressors during their ICU stay, and 20% of them required renal replacement therapy within the first 24 hours of their ICU stay. Severe metabolic or mixed acidemia was associated with a mortality rate of 57% in the ICU. Delay of acidemia recovery as opposed to initial pH value was associated with increased mortality in the ICU. The type of acidemia did not influence the decision to administer sodium bicarbonate.
conclusionsThe incidence of severe metabolic or mixed acidemia in critically ill patients was 6% in the present study, and it was associated with a 57% mortality rate in the ICU. In contradistinction with the initial acid-base parameters, the rapidity of acidemia recovery was an independent risk factor for mortality. Sodium bicarbonate prescription was very heterogeneous between ICUs. Further studies assessing specific treatments may be of interest in this population.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.