Evidence map›Paper›PMID 39800791›Full record

Trial reportEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2025

Effect of isotonic sodium bicarbonate infusion on perioperative acid-base status among patients undergoing emergency laparotomy for perforation peritonitis (ISABEL trial): a randomized controlled trial.

Rahul Kumar Chaudhary, Ankita Dhir, Venkata Ganesh, Ajay Singh, Naveen B Naik, Priyankar Kumar Datta, Shiv Lal Soni, Narender Kaloria, Yashwant Raj Sakaray

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Rahul Kumar ChaudharyDepartment of Anaesthesia & Intensive Care, Postgraduate Institute of Medical Education and Research (PGIMER), Sector-12, Chandigarh, 160012, India.
Ankita DhirDepartment of Anaesthesia & Intensive Care, Postgraduate Institute of Medical Education and Research (PGIMER), Sector-12, Chandigarh, 160012, India.
Venkata GaneshDepartment of Anaesthesia & Intensive Care, Postgraduate Institute of Medical Education and Research (PGIMER), Sector-12, Chandigarh, 160012, India.
Ajay SinghDepartment of Anaesthesia & Intensive Care, Postgraduate Institute of Medical Education and Research (PGIMER), Sector-12, Chandigarh, 160012, India. ajay.ydv2509@gmail.com.
Naveen B NaikDepartment of Anaesthesia & Intensive Care, Postgraduate Institute of Medical Education and Research (PGIMER), Sector-12, Chandigarh, 160012, India.
Priyankar Kumar DattaDepartment of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences (AIIMS), Ansari Nagar East, New Delhi, 110029, India.
Shiv Lal SoniDepartment of Anaesthesia & Intensive Care, Postgraduate Institute of Medical Education and Research (PGIMER), Sector-12, Chandigarh, 160012, India.
Narender KaloriaDepartment of Anaesthesia & Intensive Care, Postgraduate Institute of Medical Education and Research (PGIMER), Sector-12, Chandigarh, 160012, India.
Yashwant Raj SakarayDepartment of Anaesthesia & Intensive Care, Postgraduate Institute of Medical Education and Research (PGIMER), Sector-12, Chandigarh, 160012, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePerioperative metabolic acidosis negatively affects patient outcomes. Perioperative fluid therapy has a clinically significant effect on acid-base balance. This study was conducted to evaluate the effects of isotonic sodium bicarbonate infusion (ISB) versus balanced crystalloid solution (BCS) on perioperative acid-base balance, in terms of postoperative base excess, among patients undergoing emergency laparotomy for perforation peritonitis.

methodsThis prospective, randomized, single-center, double-blinded study was conducted in a tertiary hospital from October 2021 to November 2022. A total of 90 patients undergoing emergency laparotomy for perforation peritonitis were randomly assigned to receive either isotonic sodium bicarbonate (ISB) or Ringer's Lactate as a balanced crystalloid solution (BCS) for perioperative maintenance fluid therapy. The primary outcome was to compare the base excess (BE) at the end of surgery. The secondary outcomes were to compare the postoperative clinical outcomes, including the requirement of vasopressors, duration of mechanical ventilation, HDU/ICU stay, the incidence of AKI within seven days, the incidence of re-exploration, and in-hospital mortality. Additionally, pH, PaCO2, HCO3, BE, and lactates intraoperatively and up to 24 h postoperatively were also compared.

resultsThe median base excess (BE) values at the end of surgery were significantly better in the ISB group - 4.80 [- 6.80, - 4.10] as compared to the BCS group - 7.30 [- 8.50, - 6.30]. The ISB group had a lower incidence of postoperative AKI (9% ISB versus 24% BCS) and requirement of vasopressors (18% ISB versus 44% BCS). However, there was no major difference between the incidence of re-exploration, length of ICU/HDU stay, and in-hospital mortality.

conclusionInfusing isotonic sodium bicarbonate (ISB) for intraoperative maintenance fluid therapy in patients undergoing emergency laparotomy for perforation peritonitis significantly improves perioperative acid-base balance with better postoperative clinical outcomes compared to a balanced crystalloid solution (BCS).

Indexed as

Acid-Base EquilibriumFluid TherapyIntestinal PerforationLaparotomyPeritonitisSodium BicarbonateAcidosisAgedCrystalloid SolutionsDouble-Blind MethodFemaleHospital MortalityHumansMaleMiddle AgedPerioperative CareCrystalloid SolutionsRinger's LactateSodium BicarbonateIsotonic sodium bicarbonateMajor abdominal surgeryPerforation peritonitisPerioperative fluid therapyPerioperative metabolic acid–base disorders

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Registered trials

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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.