title: The effects of sodium bicarbonate during prolonged cardiopulmonary resuscitation.
abstract: BACKGROUND
  This study was performed to determine the effects of sodium bicarbonate injection during prolonged cardiopulmonary resuscitation (for >15 minutes).
  
  
  METHODS
  The retrospective cohort study consisted of adult patients who presented to the emergency department (ED) with the diagnosis of cardiac arrest in 2009. Data were retrieved from the institutional database.
  
  
  RESULTS
  A total of 92 patients were enrolled in the study. Patients were divided into 2 groups based on whether they were treated (group1, n = 30) or not treated (group 2, n = 62) with sodium bicarbonate. There were no significant differences in demographic characteristics between groups. The median time interval between the administration of CPR and sodium bicarbonate injection was 36.0 minutes (IQR: 30.5-41.8 minutes). The median amount of bicarbonate injection was 100.2 mEq (IQR: 66.8-104.4). Patients who received a sodium bicarbonate injection during prolonged CPR had a higher percentage of return of spontaneous circulation, but not statistical significant (ROSC, 40.0% vs. 32.3%; P = .465). Sustained ROSC was achieved by 2 (6.7%) patients in the sodium bicarbonate treatment group, with no survival to discharge. No significant differences in vital signs after ROSC were detected between the 2 groups (heart rate, P = .124; systolic blood pressure, P = .094). Sodium bicarbonate injection during prolonged CPR was not associated with ROSC after adjust for variables by regression analysis (Table 3; P = .615; odds ratio, 1.270; 95% confidence interval: 0.501-3.219)
  
  
  CONCLUSIONS
  The administration of sodium bicarbonate during prolonged CPR did not significantly improve the rate of ROSC in out-of-hospital cardiac arrest.
authors.affiliation: Department of Emergency Medicine, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Tao-Yuan, Taiwan.
authors.forename: Yi-Ming
authors.initials: YM
authors.lastname: Weng
authors.forename: Shih-Hao
authors.initials: SH
authors.lastname: Wu
authors.forename: Wen-Cheng
authors.initials: WC
authors.lastname: Li
authors.forename: Chan-Wei
authors.initials: CW
authors.lastname: Kuo
authors.forename: Shou-Yen
authors.initials: SY
authors.lastname: Chen
authors.forename: Jih-Chang
authors.initials: JC
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D003131:Combined Modality Therapy; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D017693:Sodium Bicarbonate / Q000627:therapeutic use*; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002316:Cardiotonic Agents; D017693:Sodium Bicarbonate