ArticleTurkish journal of emergency medicine
Efficacy of bicarbonate therapy for adults with cardiac arrest: A systematic review and meta-analysis of randomized-controlled trials.
Article in Turkish journal of emergency medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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0 citing papers in PubMed, 2 citations in OpenAlex.
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2 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
objectivesBecause the benefits of bicarbonate therapy remain unclear, it is not routinely recommended for the cardiopulmonary resuscitation (CPR) given to individuals with cardiac arrest (CA). This study aims to evaluate the clinical benefits of bicarbonate therapy in adults with CA.
methodsWithout any language restriction, we searched PubMed/MEDLINE, Scopus, Web of Science, and Cochrane CENTRAL from the inception until April 30, 2020. We performed hand-search to identify the relevant trials included in previous meta-analyses. Included studies were randomized controlled trials (RCTs) comparing bicarbonate and placebo treatment in adults with CA. Two authors independently assessed the trial risk of bias. The primary outcome was the survival to hospital admission. The secondary outcomes included the return of spontaneous circulation, the survival to hospital discharge, and the neurological outcome at discharge. We calculated the odds ratios of those outcomes using the Mantel-Haenszel model and assessed the heterogeneity using the I
resultsOur searches found 649 unduplicated studies. Of these, three RCTs involving 1344 patients were included in the meta-analysis. The trial risk of bias ranged between fair and poor, mainly due to no blindness of outcome assessment and the selective reports of outcomes. Bicarbonate therapy showed no significant improvement in the survival to hospital admission (odds ratio [OR] 0.96; 95% confidence interval [CI] 0.73-1.25). Subgroup analysis in those receiving prolonged CPR showed a similar result (OR 0.88; 95% CI 0.10-8.01). No study reported the predefined secondary outcomes.
conclusionFor both acute and prolonged CPR, bicarbonate therapy might not show benefit to improve the rate of survival to hospital admission in adults with cardiac arrest.
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