Efficacy of bicarbonate therapy for adults with cardiac arrest: A systematic review and meta-analysis of

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Wachira Wongtanasarasin1, Karan Srisurapanont1

  • 1Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

Turkish Journal of Emergency Medicine
|February 12, 2021
PubMed

Insights

Bicarbonate therapy does not appear to improve survival rates for adults experiencing cardiac arrest (CA) during cardiopulmonary resuscitation (CPR). This meta-analysis found no significant benefit for hospital admission survival in acute or prolonged CPR cases.

Area of Science:

  • Emergency Medicine
  • Critical Care
  • Pharmacology

Background:

  • Bicarbonate therapy's role in cardiopulmonary resuscitation (CPR) for cardiac arrest (CA) is not well-established.
  • Current guidelines do not routinely recommend bicarbonate therapy due to unclear benefits.

Purpose of the Study:

  • To evaluate the clinical benefits of administering bicarbonate therapy to adult patients suffering from cardiac arrest.

Main Methods:

  • A systematic meta-analysis of randomized controlled trials (RCTs) was conducted, searching major databases up to April 2020.
  • Three RCTs involving 1344 patients were included, comparing bicarbonate therapy against placebo in adult CA patients.
  • Primary outcome was survival to hospital admission; secondary outcomes included circulation return, discharge survival, and neurological status.

Main Results:

  • Bicarbonate therapy demonstrated no significant improvement in survival to hospital admission (OR 0.96; 95% CI 0.73-1.25).
  • Subgroup analysis for prolonged CPR yielded similar non-significant results (OR 0.88; 95% CI 0.10-8.01).
  • The quality of included trials was rated as fair to poor, with limitations in blinding and reporting.

Conclusions:

  • Bicarbonate therapy may not offer benefits for improving hospital admission survival rates in adults with cardiac arrest, regardless of CPR duration.
  • Further high-quality research is needed to definitively ascertain the efficacy of bicarbonate in cardiac arrest management.
Abstract

Keywords:
Bicarbonatecardiac arrestmeta-analysissurvivalsystematic review

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