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Sodium bicarbonate in cardiac resuscitation

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Indications for sodium bicarbonate are severe metabolic acidosis during prolonged cardiac or respiratory arrest - the diagnosis must be supported by blood gases.

In most cases the acidosis of cardiac arrest should be corrected by CPR; however, in longer arrests lactic acid production may occur as a result of anaerobic respiration will cause a metabolic acidosis which may need correction. Note that the acidosis will be mostly venous; arterial gases may give misleading results.

It acts to:

  • increase the threshold for going into VF
  • improves the action of catecholamines
  • improves myocardial contractility

Its actions have not been confirmed in any satisfactory trial.


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