Scholarlink

Background <p>Sodium bicarbonate is commonly used to correct metabolic acidosis in pediatric patients, yet its efficacy remains controversial. This study aims to assess its effectiveness in treating non-lactic and lactic metabolic acidosis and its impact at various chloride levels.</p> Methods <p>A retrospective cohort study was conducted by screening pediatric patients diagnosed with metabolic acidosis from a paediatric intensive care database. Patients were categorized into two groups: lactate patients (lactate &gt; 2.0&#xa0;mmol/L) and non-lactate patients (lactate ≤ 2.0&#xa0;mmol/L). The risk of death in patients who received sodium bicarbonate was assessed.</p> Results <p>Sodium bicarbonate treatment did not significantly affect in-hospital mortality in either overall lactate patients or non-lactate patients, with adjusted OR of 1.044 (95% CI: 0.829–1.315, <i>p</i> = 0.714) and 0.838 (95% CI: 0.548–1.281, <i>p</i> = 0.414), respectively. In lactate patients, those receiving sodium bicarbonate had a higher risk of in-hospital death when chloride was &lt; 107&#xa0;mmol/L (adjusted OR = 2.195, 95% CI: 1.536–3.135, <i>p</i> &lt; 0.001), whereas the risk of in-hospital death decreased when chloride was ≥ 113&#xa0;mmol/L (adjusted OR = 0.365, 95% CI: 0.217–0.614, <i>p</i> &lt; 0.001). Similar findings were observed in non-lactate patients.</p> Conclusions <p>Sodium bicarbonate treatment does not improve the survival of pediatric patients with lactate or non-lactate metabolic acidosis. However, it can reduce the odds of mortality in pediatric patients with hyperchloremia, regardless of their lactate levels. Prospective studies are needed to further confirm these findings.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Sodium bicarbonate in treating lactic and non-lactic metabolic acidosis at different chloride levels: a retrospective study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年6月5日

查看全文
  • Jian Wu,
  • Ling Lai,
  • Xiaoyan Xue,
  • Shuiyan Wu,
  • Huaqing Liu

摘要

Background

Sodium bicarbonate is commonly used to correct metabolic acidosis in pediatric patients, yet its efficacy remains controversial. This study aims to assess its effectiveness in treating non-lactic and lactic metabolic acidosis and its impact at various chloride levels.

Methods

A retrospective cohort study was conducted by screening pediatric patients diagnosed with metabolic acidosis from a paediatric intensive care database. Patients were categorized into two groups: lactate patients (lactate > 2.0 mmol/L) and non-lactate patients (lactate ≤ 2.0 mmol/L). The risk of death in patients who received sodium bicarbonate was assessed.

Results

Sodium bicarbonate treatment did not significantly affect in-hospital mortality in either overall lactate patients or non-lactate patients, with adjusted OR of 1.044 (95% CI: 0.829–1.315, p = 0.714) and 0.838 (95% CI: 0.548–1.281, p = 0.414), respectively. In lactate patients, those receiving sodium bicarbonate had a higher risk of in-hospital death when chloride was < 107 mmol/L (adjusted OR = 2.195, 95% CI: 1.536–3.135, p < 0.001), whereas the risk of in-hospital death decreased when chloride was ≥ 113 mmol/L (adjusted OR = 0.365, 95% CI: 0.217–0.614, p < 0.001). Similar findings were observed in non-lactate patients.

Conclusions

Sodium bicarbonate treatment does not improve the survival of pediatric patients with lactate or non-lactate metabolic acidosis. However, it can reduce the odds of mortality in pediatric patients with hyperchloremia, regardless of their lactate levels. Prospective studies are needed to further confirm these findings.