Faculty Collaboration Database

Prehospital bicarbonate use in cardiac arrest: a 3-year experience. Am J Emerg Med 1992 Jan;10(1):4-7

Date

01/01/1992

Pubmed ID

1736913

DOI

10.1016/0735-6757(92)90115-e

Scopus ID

2-s2.0-0026591226 (requires institutional sign-in at Scopus site)   58 Citations

Abstract

The American Heart Association no longer recommends the routine use of sodium bicarbonate in cardiac arrests. Reasons cited include the lack of documented effect on clinical outcome and potential adverse effects of metabolic alkalosis and hypernatremia. We reviewed 36 months of experience with 619 nontrauma adult, prehospital cardiac arrest patients to identify 273 successful resuscitations who had emergency department blood gases and electrolytes performed. Determination of complications associated with prehospital intravenous sodium bicarbonate and its impact on survival in resuscitated patients was undertaken. Fifty-eight patients did not receive sodium bicarbonate (NO HCO3 group) and had short cardiopulmonary resuscitation (CPR) times (7.4 +/- 5.5 minutes). Two hundred fifteen patients did receive sodium bicarbonate (HCO3 group) and had significantly longer CPR times (23.3 +/- 13.5 minutes, P less than or equal to .001). Both groups demonstrated routine early chest compression and hyperventilation as evidenced by no significant difference in paramedic response time or rate of intubations. Initial emergency department blood gas results of both groups were not significantly different. No patients in the NO HCO3 group had hypernatremia (sodium [Na]+ greater than 150), whereas four patients (2%) in the HCO3 group were hypernatremic. Eight patients (14%) in the NO HCO3 group and 37 patients (17%) in the HCO3 group were alkalotic with pH values greater than 7.49 (P = NS). Six patients (10%) of the NO HCO3 group and 24 patients (11%) of the HCO3 group had a metabolic component to the alkalosis as defined by a positive base excess value (P = NS).(ABSTRACT TRUNCATED AT 250 WORDS)

Author List

Aufderheide TP, Martin DR, Olson DW, Aprahamian C, Woo JW, Hendley GE, Hargarten KM, Thompson B

Author

Tom P. Aufderheide MD Professor in the Emergency Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Acid-Base Equilibrium
Aged
Bicarbonates
Carbon Dioxide
Data Interpretation, Statistical
Electrolytes
Emergency Medical Services
Female
Heart Arrest
Humans
Male
Middle Aged
Oxygen
Resuscitation
Retrospective Studies
Survival Analysis