Meta-Analysishigh evidence
Sodium bicarbonate therapy in severe metabolic acidemia: an individual patient data meta-analysis of the BICAR-ICU and BICAR-ICU2 trials.
Critical care (London, England)·July 19, 2026·PMID 42472834
Why it mattersSevere metabolic acidemia in critically ill patients often prompts consideration of RRT, but the role of sodium bicarbonate remains debated. This meta-analysis clarifies that bicarbonate reduces the need for RRT and may improve survival in the sickest patients with pH ≤ 7.10, offering a targeted intervention to avoid dialysis.
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