In this episode, episode 98, I discuss the BICAR-ICU trial and what it tells us about using sodium bicarbonate to treat metabolic acidosis.
References:
BICAR-ICU Trial: https://www.ncbi.nlm.nih.gov/pubmed/29910040
BICAR-ICU Editorial: https://www.ncbi.nlm.nih.gov/pubmed/29910039
Forsythe: https://www.ncbi.nlm.nih.gov/pubmed/10631227
Sabatini: https://www.ncbi.nlm.nih.gov/pubmed/18322160
Pulmcrit post: https://emcrit.org/pulmcrit/bicar-icu/
What do you think about a bicarbonate infusion that is already running and comes to the or.
I usually keep it going for the 1-3 hour case but I don’t have any data
Also I think an accrac Facebook group would be awesome.
It’d be cool for articles and questions maintaining knowledge etc
Hi Mario,
Depends on why it is running. I would have a discussion with the team from the floor or ICU to discuss why it is running and whether to keep it going. Will definitely think about the facebook idea, thanks.
Best,
Jed
Hello, Dr Jed. This podcast is fantastic. I would like to thank you for sharing such important topics with the Critical Care community.
I have the same problem here in Brazil with Bicarb administration when it comes to Cardiac postop patients. Acidosis is the terrible villain and Bicarb is the hero for our pals, cardiac surgeons. The BICAR-ICU paper and the episode 24, “The Evils of Sodium Bicarbonate” with its references are key for calling its use into question.
But even so, how hard it is to change ingrained habits in Medicine. The grip of prevailing dogma is difficult to loosen. It is more like a human psychological issue, I guess – our desperation for some sort of control over an indifferent universe – the patient.
Thanks Luciano, keep up the great work!