Therapeutic effectiveness of sodium bicarbonate in diabetic ketoacidosis: A retrospective cohort analysis using the marginal structural Cox model.

ABSTRACT: The treatment effect of sodium bicarbonate in diabetic ketoacidosis (DKA) remains controversial, as clinical guidelines recommend its use only in extreme acidemia (pH < 6.9) owing to inconsistent evidence and concerns over potential risks such as paradoxical central nervous system acidosis, delayed ketone clearance, and electrolyte imbalance. This study aimed to evaluate the real-world effectiveness and safety of sodium bicarbonate therapy in critically ill patients with DKA in a large clinical database. This is a retrospective cohort study following the STROBE guidelines on the MIMIC-IV database. The propensity score matching was used to balance the baseline difference. The primary outcome was the risk of multiple organ dysfunction syndrome (MODS). Secondary outcomes were the risk of rena

SUBMITTER: Wu X 

PROVIDER: S-EPMC12863815 | biostudies-literature | 2026 Jan

REPOSITORIES: biostudies-literature