Metabolic acidosis: Difference between revisions

| treatment = '''Acute:''' IV bicarbonate therapy;<ref> name="BICAR-ICU 2018" >{{cite journal |last1=Jaber |first1=Samir |last2=Paugam |first2=Catherine |last3=Futier |first3=Emmanuel | display-authors=etal |title=Sodium bicarbonate therapy for patients with severe metabolic acidaemia in the intensive care unit (BICAR-ICU): a multicentre, open-label, randomised controlled, phase 3 trial |journal=The Lancet |volume=392 |issue=10141 |pages=31–40 |language=en |doi=10.1016/S0140-6736(18)31080-8 |pmid=29910040 |date=2018|s2cid=49276138 |url=https://hal.umontpellier.fr/hal-01818634/file/2018%20Jaber%20et%20al.%20Sodium%20bicarbonate%20therapy.pdf }}</ref><br>

Bicarbonate therapy is generally administered In patients with severe acute acidemia (pH < 7.11), or with less severe acidemia (pH 7.1-7.2) who have severe acute kidney injury. Bicarbonate therapy is not recommended for people with less severe acidosis (pH ≥ 7.1), unless severe acute kidney injury is present. In the BICAR-ICU trial,<ref> name="BICAR-ICU 2018"< /ref> bicarbonate therapy for maintaining a pH >7.3 had no overall effect on the composite outcome of all-cause mortality and the presence of at least one organ failure at day 7. However, amongst the sub-group of patients with severe acute kidney injury, bicarbonate therapy significantly decreased the primary composite outcome, and 28-day mortality, along with the need for [[kidney dialysis|dialysis]].