Table 1.
Clinical studies evaluating bicarbonate use in sepsis patients with acidosis. Studies are listed in chronological order, based on year of publication.
| Reference | Country, year | Study design | Results |
|---|---|---|---|
| Cooper et al. [1] | British Columbia, Canada, 1990 | Prospective, randomized, blinded, crossover study, 14 patients | Sodium bicarbonate did not improve hemodynamics or the response to catecholamines and caused hypocalcemia and hypercarbia |
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| Mathieu et al. [2] | Lille, France, 1991 | Prospective, randomized, blinded, crossover study, 10 patients | Sodium bicarbonate increased arterial and venous pH, serum bicarbonate, and arterial and venous blood pCO2, but hemodynamic responses similar to sodium chloride |
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| Fang et al. [3] | Nanjing, China, 2008 | Prospective, randomized trial, 94 patients | 5% sodium bicarbonate for resuscitation in severe sepsis with hypotension improved blood pressure and cardiac output earlier than saline or hypertonic sodium chloride, indicating limited benefit from bicarbonate in sepsis |
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| Noritomi et al. [4] | Sao Paulo, Brazil, 2009 | Prospective, observational study, 60 ICU patients with severe sepsis or septic shock | Lactate reduced and metabolic acidosis corrected in survivors, but not in nonsurvivors |
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| El-Sholh et al. [5] | New York, USA, 2010 | Retrospective study, 36 patients with septic shock who received bicarbonates versus 36 matched patients who did not | Bicarbonate group had shorter duration of mechanical ventilation but no difference in 28-day mortality |
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| Jung et al. [6] | Montpellier, France, 2011 | Prospective multicenter observational study, 200 patients with severe acidosis | Bicarbonate administration in 5–55% of patients, depending on center, not on acidosis mechanism. No association between bicarbonate and outcome |
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| Chen et al. [8] | Jiangsu, China, 2013 | Prospective, randomized trial, 65 patients | Patients who received bicarbonate had improved hemodynamics, shorter mechanical ventilation, shorter ICU and hospital stay, and lower mortality |
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| Kim et al. [7] | Busan, Korea, 2013 | Retrospective study, 103 patients with lactic acidosis | Bicarbonate use was independent risk factor for increased mortality |