Comparison of two different bicarbonate replacement fluids during continuous veno-venous hemofiltration (CVVH) with RCA: a prospective, randomized, controlled trial
Authors' conclusion
LBF showed significantly lower rates of pH and HCO3- excursions compared to HBF and no significant differences to the pH normalization in acidotic patients were observed.
Study context
- Population
- Patients on CVVH with regional citrate anticoagulationcrossover
- Participants
- 88 patients
- Comparison
- HBF vs LBF
- Primary endpoint
- At least one pH/HCO3- excursion outside standard values
- Follow-up
- 96 h (two 48-h phases)
Methodological detailsprospective, open-label, cross-over, single-center
- Prospective
- Open-label
- Cross-over
- Single-center
Primary result
As reported in the abstract
≥1 pH and HCO3- excursion (levels outside standard values)
pH, first phase
pH, second phase
HCO3-, first phase
HCO3-, second phase
- Adjusted OR for ≥1 pH excursion
- 1.78 (95% CI 1.12-2.82; p = 0.015)
- Adjusted OR for ≥1 HCO3- excursion
- 3.60 (95% CI 2.16-5.99; p < 0.001)
Further findings
| Outcome | P value |
|---|---|
| Time to normalization (pH in acidotic patients; HCO3- in low HCO3-), first phaseHBF vs LBF · pH | P = 0.102 |
| Time to normalization (pH in acidotic patients; HCO3- in low HCO3-), first phaseHBF vs LBF · HCO3- | P = 0.468 |
Time to normalization (pH in acidotic patients; HCO3- in low HCO3-), first phase
- Did not differ significantly between HBF and LBF
Original publication
Comparison of two different bicarbonate replacement fluids during CVVH with RCA: a prospective, randomized, controlled trial. Intensive Care Med. Published 17 November 2025. doi:10.
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