title: Use of Sodium Bicarbonate in Cardiac Arrest: Current Guidelines and Literature Review.
abstract: 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.
authors.affiliation: Internal Medicine Department, University Hospital of Patras, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Velissaris
authors.affiliation: Internal Medicine Department, University Hospital of Patras, Greece.
authors.forename: Vassilios
authors.initials: V
authors.lastname: Karamouzos
authors.affiliation: Intensive Care Department, Brugmann University Hospital, Brussels, Belgium.
authors.forename: Charalampos
authors.initials: C
authors.lastname: Pierrakos
authors.affiliation: Cardiology Department, University Hospital of Patras, Greece.
authors.forename: Ioanna
authors.initials: I
authors.lastname: Koniari
authors.affiliation: School of Medicine, University of Patras, Greece.
authors.forename: Christina
authors.initials: C
authors.lastname: Apostolopoulou
authors.affiliation: Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Menelaos
authors.initials: M
authors.lastname: Karanikolas
keywords: Cardiac arrest; Metabolic acidosis; Resuscitation; Sodium bicarbonate