Sodium Bicarbonate for Critically Ill Adults with Metabolic Acidosis and Shock.
SODa-BIC Investigators and the Australian and New Zealand Intensive Care Society Clinical Trials Group, Ary Serpa Neto, Mairead McNamara et al.
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In 30 seconds
This randomized controlled trial evaluated the effects of sodium bicarbonate in 500 critically ill adults with metabolic acidosis receiving vasopressors. The study found no significant difference in the occurrence of major adverse kidney events within 30 days between the sodium bicarbonate group (40.2%) and the placebo group (39.4%), with an adjusted difference of 1.2 percentage points (P = 0.78).
Key findings
- Major adverse kidney events occurred in 40.2% of the sodium bicarbonate group vs 39.4% of the placebo group.
- Renal-replacement therapy was used in 16.8% of the sodium bicarbonate group compared to 20.9% in the placebo group.
- In-hospital mortality by day 30 was 25.4% in the sodium bicarbonate group and 24.0% in the placebo group.
- Adverse effects were reported in 1.6% of the sodium bicarbonate group, compared to none in the placebo group.
Why it matters
The findings suggest that sodium bicarbonate does not provide a significant benefit in preventing major kidney complications in critically ill patients with metabolic acidosis on vasopressors, which may influence treatment decisions in this population.