EBQ:Sodium Bicarbonate use in DKA: Difference between revisions

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==Con Argument==
==Con Argument==
===Trial 1===
===Trial 1===
21 patients underwent RCT
'''21 patients''' underwent RCT
* 10 patients (PH 6.9-7.14)received NaHco3
* 10 patients (PH 6.9-7.14)received NaHco<sub>3</sub>
* 11 patients in the control group
* 11 patients in the control group
Results: No differences in Glucose level, bicarb level nor PH <ref>Ann Intern Med. 1986 Dec;105(6):836-40</ref>
'''Results:''' No differences in Glucose level, bicarb level nor PH <ref>Ann Intern Med. 1986 Dec;105(6):836-40</ref>
 
===Trial 2===
===Trial 2===
Prospective, Randomized, Blinded and cross over study included '''14 patients'''
Prospective, Randomized, Blinded and cross over study included '''14 patients'''

Revision as of 12:50, 15 April 2014

Clinical Question

Should Sodium Bicarbonate be used to treat Diabetic Ketoacidosis ?

Background

Sodium bicarbonate is a solution which help alkalanizing the blood by binding the H+ and converting it to water and Co2. Many Physicians use it to treat DKA, but based on what ? Is there any evidence supporting its use ?

Pro Argument

Trial 1

Trial 2

Trial 3

Con Argument

Trial 1

21 patients underwent RCT

  • 10 patients (PH 6.9-7.14)received NaHco3
  • 11 patients in the control group

Results: No differences in Glucose level, bicarb level nor PH [1]

Trial 2

Prospective, Randomized, Blinded and cross over study included 14 patients

  • HCO3 level <17
  • Received Sodium Bicarbonate 2mmol/kg over 15 minutes
  • Results: Decreased Ionized Calcium, increased Paco2 Sodium Bicarbonate didn't improve hemodynamics[2]

Trial 3

Sources

  1. Ann Intern Med. 1986 Dec;105(6):836-40
  2. Ann Intern Med. 1990 Apr 1;112(7):492-8

http://saudiemergencymedicine.com/should-you-use-sodium-bicarbonate-in-acidosis-stop-for-a-minute/