Early sodium bicarbonate therapy for critically ill patients with septic shock and acute moderate metabolic acidosis

journals.lww.com September 12, 2024

In recent decades, septic shock has continued to be a life-threatening health problem around the world.

Meanwhile, metabolic acidosis (MA) is also well known in critically ill patients, and even moderate metabolic acidosis (MMA) is associated with higher mortality than sepsis.

Although the administration of sodium bicarbonate (SB) is widely used in sepsis shock with MA in the intensive care unit (ICU), its clinical efficacy is not well established.

In the 2021 update of the Surviving Sepsis Campaign guidelines, Evans et al. recommend the administration of SB in adults with septic shock, severe metabolic acidemia (pH ≤7.2), and acute kidney injury (AKI, AKIN score 2 or 3).

However, clinical evidence for the efficacy of the administration of SB in critically ill patients with septic shock and acute MMA is still limited.