Articles: sodium-bicarbonate.
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Eur. J. Intern. Med. · Feb 2025
Multicenter StudyHyperchloremic metabolic acidosis potentially benefiting sodium bicarbonate therapy: A multi-center cohort study.
The use of sodium bicarbonate for metabolic acidosis has been a topic of debate, primarily due to the lack of clinical efficacy evidence. This study aims to identify which types of patients with various acid-base balance parameters can benefit from sodium bicarbonate therapy. ⋯ This study identified an interaction between baseline chloride and sodium bicarbonate therapy on patient survival. Hyperchloremic metabolic acidosis may potentially benefit from sodium bicarbonate therapy. Further prospective randomized controlled studies are warranted.
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Eur J Trauma Emerg Surg · Jan 2025
Randomized Controlled TrialEffect of isotonic sodium bicarbonate infusion on perioperative acid-base status among patients undergoing emergency laparotomy for perforation peritonitis (ISABEL trial): a randomized controlled trial.
Perioperative metabolic acidosis negatively affects patient outcomes. Perioperative fluid therapy has a clinically significant effect on acid-base balance. This study was conducted to evaluate the effects of isotonic sodium bicarbonate infusion (ISB) versus balanced crystalloid solution (BCS) on perioperative acid-base balance, in terms of postoperative base excess, among patients undergoing emergency laparotomy for perforation peritonitis. ⋯ Infusing isotonic sodium bicarbonate (ISB) for intraoperative maintenance fluid therapy in patients undergoing emergency laparotomy for perforation peritonitis significantly improves perioperative acid-base balance with better postoperative clinical outcomes compared to a balanced crystalloid solution (BCS).
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Guidelines for diabetic ketoacidosis (DKA) management are limited, resulting in varied practices. This study assessed Intensive Care Unit (ICU) admission criteria, fluid resuscitation, insulin therapy, and metabolic management in adult patients with DKA. ⋯ The management of patients with DKA remains heterogeneous worldwide. Future randomized trials are needed, especially regarding fluid resuscitation and insulin therapy. Trial registrationNot applicable.
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Aims/Background Hyperuricemia is a metabolic disorder characterized by elevated levels of uric acid in the blood. If left untreated, hyperuricemia can progress to gout, which manifests as acute arthritic attacks, and may also lead to uric acid nephrolithiasis and other renal conditions. This widespread condition poses significant risks to human health and quality of life. ⋯ No statistically significant difference was found in the incidence of adverse drug reactions between the two groups (p > 0.05). Conclusion The combination of benzbromarone and sodium bicarbonate tablets is highly effective in treating gout associated with hyperuricemia. This treatment not only reduces uric acid levels and the number of tophi but also enhances renal function, alleviates pain, and improves the overall quality of life for patients.
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Intensive care medicine · Nov 2024
ReviewChallenging management dogma where evidence is non-existent, weak, or outdated: part II.
Many dogmas influence daily clinical practice, and critical care medicine is no exception. We previously highlighted the weak, questionable, and often contrary evidence base underpinning four established medical managements-loop diuretics for acute heart failure, routine use of heparin thromboprophylaxis, rate of sodium correction for hyponatremia, and 'every hour counts' for treating bacterial meningitis. We now provide four further examples in this "Dogma II" piece (a week's course of antibiotics, diabetic ketoacidosis algorithms, sodium bicarbonate to improve ventricular contractility during severe metabolic acidosis, and phosphate replacement for hypophosphatemia) where routine practice warrants re-appraisal.