Haemodynamics, fluids & transfusion
Sodium Bicarbonate for Critically Ill Adults with Metabolic Acidosis and Shock
Primary result · Major adverse kidney eventResult — go to the resultAdjusted difference 1.2 percentage points 95% CI −7.1 to 9.4Authors' conclusion
The use of sodium bicarbonate in critically ill patients with metabolic acidosis receiving vasopressors did not lead to a lower risk of major adverse kidney events within 30 days than placebo.
Study context
- Population
- Adults in the intensive care unit (ICU) receiving vasopressors with metabolic acidosis (pH <7.30; base excess ≤−4 mmol/L; PaCO2 ≤45 mm Hg without intubation or ≤50 mm Hg with intubation)
- Participants
- 500 adults · 55 ICUs · 7 countries
- Comparison
- Sodium bicarbonate vs Placebo
- Sodium bicarbonaten = 245
- Placebon = 255reference
- Primary endpoint
- Major adverse kidney event:
- Death
- RRT
- Persistent renal dysfunction
- Follow-up
- 30 days
Methodological detailspragmatic, adaptive, double-blind, placebo-controlled, multicentre
- Pragmatic
- Adaptive
- Double-blind
- Placebo-controlled
- Multicentre
Primary result
Major adverse kidney event
Adjusted difference
1.2 percentage points
95% CI −7.1 to 9.4
P = 0.78
Events by treatment group
Sodium bicarbonate vs Placebo
adjusted difference 1.2 percentage points (95% CI −7.1 to 9.4); P = 0.78
As reported in the abstract
Further findings
| Outcome | Sodium bicarbonate | Placebo | Adjusted difference (percentage points) (95% CI) | |
|---|---|---|---|---|
| RRT use · 30 days | 16.8% | 20.9% | −3.9 (−10.6 to 2.7) | |
| In-hospital mortality · day 30 | 25.4% | 24.0% | 1.8 (−5.6 to 9.2) | |
| −15−10−50510Difference, percentage points (linear scale) |
Safety
| Outcome | Sodium bicarbonate | Placebo | P value |
|---|---|---|---|
| Adverse effect | 1.6% | 0 events | P = 0.06 |
Original publication
Sodium Bicarbonate for Critically Ill Adults with Metabolic Acidosis and Shock. N Engl J Med. Published 12 June 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →