Prevalence of Sodium Bicarbonate–Induced Alkalemia in Cardiopulmonary Arrest Patients

Geraci, Matthew J.; Klipa, Dusko; Heckman, Michael G.; Persoff, Jason

doi:10.1345/aph.1l709

Cited by 10 publications

(7 citation statements)

References 21 publications

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“…Use of sodium bicarbonate during resuscitation of cardiac arrest is controversial. 16 We currently however do not use sodium bicarbonate injection or infusion as earlier.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of in-hospital, out of intensive care and operation theatre cardiac arrests in a tertiary referral hospital

Chakravarthy

Mitra

Nonis

2012

Indian Heart Journal

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Objective: Cardiac arrest in the hospital wards may not receive as much attention as it does in the operation theatre and intensive care unit (ICU). The experience and the qualifications of personnel in the ward may not be comparable to those in the other vital areas of the hospital. The outcome of cardiac arrest from the ward areas is a reasonable surrogate of training of the ward nurses and technicians in cardiopulmonary resuscitation. We conducted an audit to assess the issues surrounding the resuscitation of cardiac arrest in areas other than operation theatre and ICU in a tertiary referral hospital. Aims of the audit:To assess the outcomes of cardiac arrest in a tertiary referral hospital. Areas such as wards, dialysis room and emergency room were considered for the audit.Methods: This is a retrospective observational audit of the case records of all the adult patients who were resuscitated from 'code blue'. Data for 2 years from 2007 was analysed by a research fellow unconnected with the resuscitations.Results: Twenty-two thousand three hundred and forty-four patients were admitted as in-patients to the hospital during the 2 years, starting May 2007 through May 2009. One hundred code blue calls were received during this time. Twenty-two of the total calls received were false. Among the 78 confirmed cardiac arrests 69 occurred in the wards, 2 in emergency room, 1 in cardiac catheterisation laboratory and 3 in dialysis room. Twenty-eight patients were declared dead after unsuccessful cardiopulmonary resuscitation. Among the 50 who were resuscitated with a return of spontaneous rhythm 26 died. Twenty-four patients were discharged (survival rate of 30%). The survival decreased significantly as the age progressed beyond 60. The resuscitation rates were better in day shifts in contrast to the night. Higher survival was noted in patients who received resuscitation in less than a minute. Conclusion:A overall survival to discharge rate of 30% was noted in this audit. Higher survival rates might be attributable to high rate and degree of training at the time of their employment, which was repeated at yearly interval.

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“…Use of sodium bicarbonate during resuscitation of cardiac arrest is controversial. 16 We currently however do not use sodium bicarbonate injection or infusion as earlier.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of in-hospital, out of intensive care and operation theatre cardiac arrests in a tertiary referral hospital

Chakravarthy

Mitra

Nonis

2012

Indian Heart Journal

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“…Parenteral SB administration has known adverse effects, including hypokalemia, hypocalcemia, hyperosmolarity, and metabolic alkalosis, any one of which may induce life-threatening consequences (5)(6)(7). Increases in arterial pH also shift the oxyhemoglobin dissociation curve to the left, causing hemoglobin to bind oxygen more tightly (8).…”

mentioning

confidence: 99%

Sodium Bicarbonate Use in Shock and Cardiac Arrest

Parker¹,

Parshuram²

2013

Critical Care Medicine

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“…In patients where ABG data were available, bicarbonate administration was linked to alkalemia in 16% (10 of 61) of patients. The authors suggested that early ABG analysis in cardiac arrest may help optimize pH and reduce the frequency of empiric, not warranted, bicarbonate use [ 18 ].…”

Section: Literature Search Resultsmentioning

confidence: 99%

“…Although patients who received bicarbonate had higher percentage of ROSC, regression analysis showed that bicarbonate administration did not significantly improve the rate of ROSC in out-of-hospital cardiac arrest [ 21 ]. The findings of all the above clinical studies are summarized in Table 1 [ 4 , 9-12 , 15 , 16 , 18 , 21-28 ]. Studies in the table are listed in alphabetical order based on the first author’s last name.…”

Section: Literature Search Resultsmentioning

confidence: 99%

Use of Sodium Bicarbonate in Cardiac Arrest: Current Guidelines and Literature Review

et al. 2016

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The aim of the review was to summarize the literature over the last 25 years regarding bicarbonate administration in out-of-hospital cardiac arrest. A PubMed search was conducted using the terms “bicarbonates” and “cardiac arrest”, limited to human studies and reviews published in English (or at least with a meaningful abstract in English) in the last 25 years. Clinical and experimental data raised questions regarding the safety and effectiveness of sodium bicarbonate (SB) administration during cardiac arrest. Earlier advanced cardiac life support (ACLS) guidelines recommended routine bicarbonate administration as part of the ACLS algorithm, but recent guidelines no longer recommend its use. The debate in the literature is ongoing, but at the present time, SB administration is only recommended for cardiac arrest related to hypokalemia or overdose of tricyclic antidepressants. Several studies challenge the assumption that bicarbonate administration is beneficial for treatment of acidosis in cardiac arrest. At the present time, there is a trend against using bicarbonates in cardiac arrest, and this trend is supported by guidelines published by professional societies and organizations.

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Prevalence of Sodium Bicarbonate–Induced Alkalemia in Cardiopulmonary Arrest Patients

Abstract: Administration of SB during CPA was causally linked with inducing alkalemia in 16% of patients. Early collection of ABG samples may assist in optimizing pH during CPA and thus reduce unwarranted empiric use of SB.

Cited by 10 publications

References 21 publications

Outcomes of in-hospital, out of intensive care and operation theatre cardiac arrests in a tertiary referral hospital

Outcomes of in-hospital, out of intensive care and operation theatre cardiac arrests in a tertiary referral hospital

Sodium Bicarbonate Use in Shock and Cardiac Arrest

Use of Sodium Bicarbonate in Cardiac Arrest: Current Guidelines and Literature Review

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