Role of sodium bicarbonate in resuscitation of out-of-hospital cardiac arrest

Objective: To report the use of sodium bicarbonate (SB) in out-of-hospital cardiac arrest (OHCA) and to explore the role of sodium bicarbonate in resuscitation of OHCA in terms of restoration of spontaneous circulation (ROSC) and survival, and existence of dose-dependent relationship, especially in...

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Bibliographic Details
Published in:Hong Kong journal of emergency medicine 2015-09, Vol.22 (5), p.281-290
Main Authors: Chung, CW, Lui, CT, Tsui, KL
Format: Article
Language:English
Subjects:
Buffers
Cardiac arrest
cardiopulmonary resuscitation
Dosage
Drugs
Emergency medical services
heart arrest
Resuscitation
Sodium bicarbonate
Treatment
treatment outcome
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Summary:Objective: To report the use of sodium bicarbonate (SB) in out-of-hospital cardiac arrest (OHCA) and to explore the role of sodium bicarbonate in resuscitation of OHCA in terms of restoration of spontaneous circulation (ROSC) and survival, and existence of dose-dependent relationship, especially in those with prolonged arrest. Design: Retrospective cohort study. Setting: Emergency department of two regional hospitals in a cluster of Hong Kong. Methods: Adult patients aged at least 18 years old who presented to the study centres with non-traumatic OHCA in the period between March 2013 and December 2013 were included. Cases in which resuscitations were considered medically futile or not actually performed were excluded. Those with do-not-resuscitate (DNR) order or advance directives, those who were death before arrival with postmortem changes, and those who developed ROSC before or within 15 minutes of arrival were excluded from the study. Patients with known poisoning from tricyclic antidepressant or other sodium channel blockers were excluded from analysis if any. The primary outcome of this study was ROSC. Other outcome variables included survival to hospital admission (STA) and survival to hospital discharge (STD). Results: A total of 489 patients were included during the study period for analysis. We found that patients who received sodium bicarbonate injection (SB group) during CPR had a higher percentage of ROSC than those who did not (no-SB group) (60.8% vs 22.5%; p100 ml) of sodium bicarbonate; however, we fail to demonstrate its benefit for prolonged CPR cases (>30 minutes).
ISSN:1024-9079
2309-5407
DOI:10.1177/102490791502200504