ReviewThe Journal of emergency medicine2023
A Review of Bicarbonate Use in Common Clinical Scenarios.
Review in The Journal of emergency medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 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
20 citing papers in PubMed, 33 citations in OpenAlex.
- Therapeutic value of continuous subcutaneous insulin infusion with electrolyte supplementation for pediatric diabetic ketoacidosis.European journal of pediatrics · 2026Trial
- Acute sodium bicarbonate supplementation reduces the increase in markers of acute kidney injury during physical work in the heat.European journal of applied physiology · 2025Trial
- Localized antithrombotic but minimal systemic coagulation effects of sodium bicarbonate in mechanical circulatory support.Journal of thrombosis and thrombolysis · 2026Article
- Sodium bicarbonate application for the treatment of acute metabolic acidosis: what we know and what we still don't know.Intensive care medicine · 2026Article
- Sodium bicarbonate therapy for metabolic acidosis in children stratified by acute kidney injury status and chloride levels: a retrospective cohort study.Translational pediatrics · 2026Article
- Cardiopulmonary arrest and cardiopulmonary resuscitation in pregnancy Number 3 - 2026.Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2026Article
- When diabetic ketoacidosis becomes a neurological emergency: cerebral edema in a child with new-onset type 1 diabetes mellitus - a case report and narrative review.Frontiers in endocrinology · 2026Review
- Physiologic response to sodium bicarbonate administration during pediatric in-hospital cardiac arrest.Frontiers in medicine · 2026Article
- Unraveling NAGMA: A Case Series of Intravenous Nimodipine-Induced Metabolic Acidosis in Neuro-ICU Patients.Asian journal of neurosurgery · 2025Article
- Sodium bicarbonate in treating lactic and non-lactic metabolic acidosis at different chloride levels: a retrospective study.BMC pediatrics · 2025Article
- Sodium bicarbonate administration for metabolic acidosis in the intensive care unit: a target trial emulation.Intensive care medicine · 2025Article
- Research Priorities for Diabetic Ketoacidosis: An Evidence and Gap Mapping Review.Medical sciences (Basel, Switzerland) · 2025Review
- Predictive value of venous bicarbonate levels for survival to hospital discharge in out-of-hospital cardiac arrest patients.International journal of emergency medicine · 2025Article
- Point-of-Care Testing (POCT) for Blood Gas and Electrolyte Analysis in Out-of-Hospital Cardiac Arrests' Management; a Cross-sectional Study.Archives of academic emergency medicine · 2025Article
- Article
- A newly developed, easy-to-use prehospital drug-derived score compared with three conventional scores: A prospective multicenter study.European journal of clinical investigation · 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
- Pyroglutamic acidosis in the setting ofClinical case reports · 2024Article
- Sodium bicarbonate and intubation in severe diabetic ketoacidosis: are we too quick to dismiss them?Clinical diabetes and endocrinology · 2024Article
- Relationship between baseline bicarbonate and 30-day mortality in patients with non-traumatic subarachnoid hemorrhage.Frontiers in neurology · 2023Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThe use of sodium bicarbonate to treat metabolic acidosis is intuitive, yet data suggest that not all patients benefit from this therapy.
objectiveIn this narrative review, we describe the physiology behind commonly encountered nontoxicologic causes of metabolic acidosis, highlight potential harm from the indiscriminate administration of sodium bicarbonate in certain scenarios, and provide evidence-based recommendations to assist emergency physicians in the rational use of sodium bicarbonate. DISCUSSION: Sodium bicarbonate can be administered as a hypertonic push, as a resuscitation fluid, or as an infusion. Lactic acidosis and cardiac arrest are two common scenarios where there is limited benefit to routine use of sodium bicarbonate, although certain circumstances, such as patients with concomitant acute kidney injury and lactic acidosis may benefit from sodium bicarbonate. Patients with cardiac arrest secondary to sodium channel blockade or hyperkalemia also benefit from sodium bicarbonate therapy. Recent data suggest that the use of sodium bicarbonate in diabetic ketoacidosis does not confer improved patient outcomes and may cause harm in pediatric patients. Available evidence suggests that alkalinization of urine in rhabdomyolysis does not improve patient-centered outcomes. Finally, patients with a nongap acidosis benefit from sodium bicarbonate supplementation.
conclusionsEmpiric use of sodium bicarbonate in patients with nontoxicologic causes of metabolic acidosis is not warranted and likely does not improve patient-centered outcomes, except in select scenarios. Emergency physicians should reserve use of this medication to conditions with clear benefit to patients.
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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.