ArticleIntensive care medicine2025
Sodium bicarbonate administration for metabolic acidosis in the intensive care unit: a target trial emulation.
Article in Intensive care medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- 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
- Research priorities for intensive care: A stakeholder-informed priority-setting partnership.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2026Article
- Sodium bicarbonate in critical illness: Correcting acidaemia without changing outcomes?Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 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
- Article
- Impact of Renal Replacement Therapy on Severe Lactic Acidosis in Intensive Care Unit Patients: A MIMIC-IV Retrospective Replication Analysis.Kidney & blood pressure research · 2026Article
- Effect of fresh-frozen plasma transfusion on intraventricular hemorrhage risk in preterm infants with prolonged APTT: a target trial emulation with causal forest analysis.Frontiers in neuroscience · 2026Article
- Update on acute kidney injury: some progresses and a long way to go.Intensive care medicine · 2025Article
- Opportunities, challenges and future perspectives for target trial emulation in critical care clinical research.Critical care (London, England) · 2025Review
- Sodium bicarbonate in critical illness: targeted or too broad? Author's reply.Intensive care medicine · 2025Article
- Bicarbonate therapy: Resuscitating an old remedy with new evidence.Journal of the Intensive Care Society · 2025Article
Corrections and comments
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Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeSodium bicarbonate is commonly administered to treat metabolic acidosis in intensive care units (ICUs). There is limited evidence from randomized trials to support this practice, and observational studies show conflicting results. Our aim was to perform a target trial emulation evaluating the effect of bicarbonate therapy on mortality.
methodsRetrospective cohort study using data from 12 Australian ICUs. Inclusion criteria were adults with pH < 7.3 and PCO
resultsWe identified 6157 eligible admissions, of which 1764 (29%) received sodium bicarbonate. Bicarbonate therapy was associated with a 1.9% absolute mortality reduction for the primary analysis [risk ratio 0.86, 95% confidence interval (CI) 0.80 to 0.91], and significant benefits were seen across all subgroups evaluated. A similar point estimate of 2.1% was observed in the sensitivity analysis, with a sustained mortality reduction seen at 30 days.
conclusionIn this target trial emulation, bicarbonate administration was associated with a small but statistically significant reduction in mortality for patients with metabolic acidosis. Large sample sizes would be required to demonstrate this effect in a randomized trial.
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