EBQ:Sodium Bicarbonate use in DKA: Difference between revisions
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* 24 patients received sodium bicarbonate | * 24 patients received sodium bicarbonate | ||
* 15 patients control | * 15 patients control | ||
* '''Results:''' More Hypokalemia in the experiment group, No differences in clinical or biochemical parameters | * '''Results:''' More Hypokalemia in the experiment group, No differences in clinical or biochemical parameters[http://www.ncbi.nlm.nih.gov/pubmed/10628611 <ref>Crit Care Med. 1999 Dec;27(12):2690-3</ref>] | ||
==Sources== | ==Sources== | ||
Revision as of 13:30, 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: Sodium Bicarbonate decreased Ionized Calcium, increased Paco2 and didn't improve hemodynamics[2]
Trial 3
Review Article included patients with PH<7
- Results: Sodium Bicarbonate didn't decrease time to improvement nor to hospital discharge[3]
Trial 4
Retrospective Study of 39 patients with PH<7.1
- 24 patients received sodium bicarbonate
- 15 patients control
- Results: More Hypokalemia in the experiment group, No differences in clinical or biochemical parameters[4]
Sources
- ↑ Ann Intern Med. 1986 Dec;105(6):836-40
- ↑ Ann Intern Med. 1990 Apr 1;112(7):492-8
- ↑ Ann Pharmacother. 2013 Jul-Aug;47(7-8):970-5
- ↑ Crit Care Med. 1999 Dec;27(12):2690-3
http://saudiemergencymedicine.com/should-you-use-sodium-bicarbonate-in-acidosis-stop-for-a-minute/