Sodium bicarbonate administration for metabolic acidosis in the intensive care unit: a target trial emulation.

ABSTRACT:

Purpose

Sodium bicarbonate is commonly administered to treat metabolic acidosis in intensive care units (ICUs). There is limited evidence from randomized trials to support this practice, and observational studies show conflicting results. Our aim was to perform a target trial emulation evaluating the effect of bicarbonate therapy on mortality.

Methods

Retrospective cohort study using data from 12 Australian ICUs. Inclusion criteria were adults with pH < 7.3 and PCO₂ ≤ 45 mmHg within the first three days. We excluded repeat admissions, toxicology, diabetic ketoacidosis, and pre-existing end-stage renal failure. The treatment intervention was sodium-bicarbonate administration, and the primary outcome was 30-day ICU mortality with ICU discharge as a competing event.

SUBMITTER: Blank SP 

PROVIDER: S-EPMC12208957 | biostudies-literature | 2025 Jun

REPOSITORIES: biostudies-literature