Does Sodium bicarbonate improve outcomes for in-hospital cardiac arrest?
Do not initiate routine sodium bicarbonate administration for in-hospital cardiac arrest based on current evidence. The BIHCA trial did not show a benefit in sustained ROSC, suggesting this intervention is not standard of care. Continue to adhere to established resuscitation protocols while recognizing that bicarbonate administration remains controversial.
This review tackles the persistent use of sodium bicarbonate in the setting of in-hospital cardiac arrest, a practice that has seen its place diminish in modern Advanced Life Support algorithms. The discussion centers heavily on the BIHCA trial, a large randomized controlled trial that provided key data on the topic. The primary takeaway from this evidence is that there was no significant difference in the sustained return of spontaneous circulation when comparing patients who received bicarbonate versus those who received a placebo. Given these findings, the authors strongly suggest that routine administration of sodium bicarbonate should not be standard care for patients experiencing cardiac arrest in the emergency department or prehospital setting.