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A perioperative infusion of sodium bicarbonate does not improve renal function in cardiac surgery patients: a

Matthias Heringlake, Hermann Heinze, Maria Schubert

    Critical Care (London, England)
    |August 18, 2012
    PubMed

    Insights

    Perioperative sodium bicarbonate infusion did not reduce the incidence of cardiac-surgery-associated-acute-kidney-injury (CSA-AKI). This study found no renoprotective effects in a large group of cardiac surgery patients.

    Area of Science:

    • Nephrology
    • Cardiology
    • Critical Care Medicine

    Background:

    • Cardiac-surgery-associated-acute-kidney-injury (CSA-AKI) significantly increases morbidity and mortality.
    • Previous studies suggested perioperative sodium bicarbonate may reduce CSA-AKI incidence in specific cardiac surgery types.
    • This study investigates the broader application of sodium bicarbonate for CSA-AKI prevention.

    Purpose of the Study:

    • To evaluate the renoprotective efficacy of a 24-hour perioperative sodium bicarbonate infusion.
    • To assess the impact on the incidence of CSA-AKI in a diverse cardiac surgical patient population.

    Main Methods:

    • A prospective cohort analysis was conducted on 584 cardiac surgery patients.
    • Patients received either a 24-hour perioperative infusion of sodium bicarbonate or were in a control group.
    • Renal function and CSA-AKI incidence were compared between the groups.

    Main Results:

    • No significant differences in demographics or surgical characteristics were observed between groups.
    • The sodium bicarbonate group required more fluids and vasopressors.
    • Despite increased diuresis, the incidence of AKI (grades 1-3) and need for renal replacement were similar in both groups.

    Conclusions:

    • Routine perioperative administration of sodium bicarbonate did not improve postoperative renal function in cardiac surgical patients.
    • The findings do not support the use of sodium bicarbonate for preventing CSA-AKI in this population.
    Abstract

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