EBQ:Sodium Bicarbonate use in DKA: Difference between revisions
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* HCO<sub>3</sub> level <17 | * HCO<sub>3</sub> level <17 | ||
* Received Sodium Bicarbonate 2mmol/kg over 15 minutes | * Received Sodium Bicarbonate 2mmol/kg over 15 minutes | ||
''Results:'' Decreased Ionized Calcium, increased Paco<sub>2</sub> Sodium Bicarbonate didn't improve hemodynamics<ref>Ann Intern Med. 1990 Apr 1;112(7):492-8</ref> | '''Results:''' Decreased Ionized Calcium, increased Paco<sub>2</sub> Sodium Bicarbonate didn't improve hemodynamics<ref>Ann Intern Med. 1990 Apr 1;112(7):492-8</ref> | ||
===Trial 3=== | ===Trial 3=== | ||
Revision as of 12:51, 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
http://saudiemergencymedicine.com/should-you-use-sodium-bicarbonate-in-acidosis-stop-for-a-minute/