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.
To read this article in full you will need to make a payment
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D; use, select 'Corporate R&D; Professionals'
Subscribe:
Subscribe to The American Journal of Emergency MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Improved resuscitation outcome in emergency medical systems with increased usage of sodium bicarbonate during cardiopulmonary resuscitation.Acta Anaesthesiol Scand. 2005; 49: 6-15
- Buffer therapy during out-of-hospital cardiopulmonary resuscitation.Resuscitation. 1995; 29: 89-95
- Sodium bicarbonate improves outcome in prolonged prehospital cardiac arrest.Am J Emerg Med. 2006; 24: 156-161
- Prehospital bicarbonate use in cardiac arrest: a 3-year experience.Am J Emerg Med. 1992; 10: 4-7
- Buffer solutions may compromise cardiac resuscitation by reducing coronary perfusion pressure.JAMA. 1991; 266: 2121-2126
- Evidence for a detrimental effect of bicarbonate therapy in hypoxic lactic acidosis.Science. 1985; 227: 754-756
- Part 8: adult advanced cardiovascular life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.Circulation. 2010; 122: S729-S767
- Buffer administration during CPR promotes cerebral reperfusion after return of spontaneous circulation and mitigates post-resuscitation cerebral acidosis.Resuscitation. 2002; 55: 45-55
- Comparison of sodium bicarbonate, Carbicarb, and THAM during cardiopulmonary resuscitation in dogs.Crit Care Med. 1998; 26: 1397-1408
- Sodium bicarbonate may improve outcome in dogs with brief or prolonged cardiac arrest.Crit Care Med. 1995; 23: 515-522
- Sodium bicarbonate improves the chance of resuscitation after 10 minutes of cardiac arrest in dogs.Resuscitation. 2001; : 51309-51315
- Factors associated with an increased chance of survival among patients suffering from an out-of-hospital cardiac arrest in a national perspective in Sweden.Am Heart J. 2005; 149: 61-66
- Predicting survival after out-of-hospital cardiac arrest: role of the Utstein data elements.Ann Emerg Med. 2010; 55: 249-257
- Impact of community-wide deployment of biphasic waveform automated external defibrillators on out-of-hospital cardiac arrest in Taipei.Resuscitation. 2004; 63: 167-174
- EMS characteristics in an Asian metropolis.Am J Emerg Med. 1996; 14: 82-85
- Effectiveness of bystander-initiated cardiac-only resuscitation for patients with out-of-hospital cardiac arrest.Circulation. 2007; 116: 2900-2907
- Cardiopulmonary resuscitation by bystanders with chest compression only (SOS-KANTO): an observational study.Lancet. 2007; 369: 920-926
- 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.Circulation. 2005; 112: IV 1-IV 203
- Cardiac arrest and cardiopulmonary resuscitation outcome reports: update and simplification of the Utstein templates for resuscitation registries. A statement for healthcare professionals from a task force of the International Liaison Committee on Resuscitation (American Heart Association, European Resuscitation Council, Australian Resuscitation Council, New Zealand Resuscitation Council, Heart and Stroke Foundation of Canada, Inter American Heart Foundation, Resuscitation Council of Southern Africa).Resuscitation. 2004; : 233-249
Article Info
Publication History
Published online: December 13, 2012
Accepted:
November 6,
2012
Received in revised form:
November 5,
2012
Received:
September 26,
2012
Footnotes
☆Conflict of interest statement: The authors have no conflicts of interest to declare.
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
