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Sodium Bicarbonate for ICU Acidosis: New Evidence Supporting a Controversial Therapy

Sodium Bicarbonate for ICU Acidosis: New Evidence Supporting a Controversial Therapy

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In this episode of the Saving Lives Podcast, we break down a 2025 study from Intensive Care Medicine that emulates a target trial on the use of sodium bicarbonate in ICU patients with metabolic acidosis. With over 6,000 patients across 12 Australian ICUs, the study reveals a small but significant reduction in mortality and RRT use with bicarbonate therapy. Tune in to learn how this could transform our clinical approach to acidemia in the critically ill patients.

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Citation: Blank SP, Blank RM, Laupland KB, Tabah A, Gill D, Kumar A, White K, Attokaran A, Luke S, Whebell S, Garrett P, McCullough J, McIlroy P, Ramanan M; Queensland Critical Care Research Network (QCCRN). Sodium bicarbonate administration for metabolic acidosis in the intensive care unit: a target trial emulation. Intensive Care Med. 2025 Jun;51(6):1-9. doi: 10.1007/s00134-025-07979-x. Epub 2025 Jun 10. PMID: 40493225; PMCID: PMC12208957.

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