ArticleIntensive care medicine2018
Effectiveness of sodium bicarbonate infusion on mortality in septic patients with metabolic acidosis.
Article in Intensive care medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers.
What it found
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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.
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Who cites it
57 citing papers in PubMed.
- Sodium bicarbonate therapy for metabolic acidosis in children stratified by acute kidney injury status and chloride levels: a retrospective cohort study.Translational pediatrics · 2026Article
- Temperature Trajectories Are Associated With the Prognosis of Septic Patients.Emergency medicine international · 2026Article
- Nanoplatforms in sepsis storm: Multimodal synergy for precision immunomodulation and pathogen neutralizations.Pharmaceutical science advances · 2025Review
- Protocol summary and statistical analysis plan for the sodium bicarbonate for metabolic acidosis in the intensive care unit (SODa-BIC) trial.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2025Article
- Sodium bicarbonate administration for metabolic acidosis in the intensive care unit: a target trial emulation.Intensive care medicine · 2025Article
- Prehospital critical care drug-therapy and 30-day mortality in patients with acute respiratory disease.World journal of emergency medicine · 2025Article
- Association between changes in corrected anion gap and mortality among critically ill patients during ICU stay: a multicenter observational study.Frontiers in physiology · 2025Article
- Efficient and Robust Transfer Learning of Optimal Individualized Treatment Regimes with Right-Censored Survival Data.Journal of machine learning research : JMLR · 2025Article
- Complexities, Benefits, Risks, and Clinical Implications of Sodium Bicarbonate Administration in Critically Ill Patients: A State-of-the-Art Review.Journal of clinical medicine · 2024Review
- Article
- Challenging management dogma where evidence is non-existent, weak, or outdated: part II.Intensive care medicine · 2024Review
- Complex interaction of infusion volumes and confounding factors with lactate clearance in septic shock.Intensive care medicine · 2024Article
- Effect of early clinical management on metabolic acidemia in neonates with hypoxic-ischemic encephalopathy.Journal of perinatology : official journal of the California Perinatal Association · 2024Article
- Unveiling cytokine charge disparity as a potential mechanism for immune regulation.Cytokine & growth factor reviews · 2024Review
- Sodium bicarbonate and intubation in severe diabetic ketoacidosis: are we too quick to dismiss them?Clinical diabetes and endocrinology · 2024Article
- Critical Care Management of Patients After Cardiac Arrest: A Scientific Statement from the American Heart Association and Neurocritical Care Society.Neurocritical care · 2024Article
- Critical Care Management of Patients After Cardiac Arrest: A Scientific Statement From the American Heart Association and Neurocritical Care Society.Circulation · 2024Review
- Clinical efficacy of sodium bicarbonate in treating pediatric metabolic acidosis with varying level of acid-base balance parameters: a real-world study.BMC medicine · 2023Article
- A Review of Bicarbonate Use in Common Clinical Scenarios.The Journal of emergency medicine · 2023Review
- Pre-intensive care unit use of selective serotonin reuptake inhibitors and mortality in critically ill adults with mental disorders: analysis from the MIMIC-IV database.Translational psychiatry · 2023Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
objectiveAlthough sodium bicarbonate (SB) solution has been widely used in clinical practice, its effect on mortality when administered to a large population of patients with acidosis is not known. The study aimed to investigate the effectiveness of SB infusion in septic patients with metabolic acidosis.
methodsSeptic patients with metabolic acidosis were identified from the Medical Information Mart for Intensive Care (MIMIC)-III database. Propensity score (PS) was used to account for the baseline differences in the probability to receive SB or not. The marginal structural Cox model (MSCM) was employed to adjust for both baseline and time-varying confounding factors. MAIN
resultsA total of 1718 septic patients with metabolic acidosis were enrolled in the study, including 500 in the SB group and 1218 in the non-SB group. Both pH [7.16 (standard deviation (SD): 0.10) vs. 7.22 (SD: 0.07); p < 0.001] and bicarbonate concentration (BC) [11.84 (SD: 3.63) vs. 14.88 (SD: 3.36) mmol/l; p < 0.001] were significantly lower in the SB than that in the non-SB group. While there was no significant mortality effect in the overall population [hazard ratio (HR): 1.04; 95% CI 0.86-1.26; p = 0.67], SB was observed to be beneficial in patients with acute kidney injury (AKI) stage 2 or 3 and pH < 7.2 (HR 0.74; 95% CI 0.51-0.86; p = 0.021). Similar results were replicated with the MSCM.
conclusionOur study observed that SB infusion was not associated with improved outcome in septic patients with metabolic acidosis, but it was associated with improved survival in septic patients with AKI stage 2 or 3 and severe acidosis. The results need to be verified in randomized controlled trials.
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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.