Document Detail

Prehospital bicarbonate use in cardiac arrest: a 3-year experience.
MedLine Citation:
PMID:  1736913     Owner:  NLM     Status:  MEDLINE    
The American Heart Association no longer recommends the routine use of sodium bicarbonate in cardiac arrests. Reasons cited include the lack of documented effect on clinical outcome and potential adverse effects of metabolic alkalosis and hypernatremia. We reviewed 36 months of experience with 619 nontrauma adult, prehospital cardiac arrest patients to identify 273 successful resuscitations who had emergency department blood gases and electrolytes performed. Determination of complications associated with prehospital intravenous sodium bicarbonate and its impact on survival in resuscitated patients was undertaken. Fifty-eight patients did not receive sodium bicarbonate (NO HCO3 group) and had short cardiopulmonary resuscitation (CPR) times (7.4 +/- 5.5 minutes). Two hundred fifteen patients did receive sodium bicarbonate (HCO3 group) and had significantly longer CPR times (23.3 +/- 13.5 minutes, P less than or equal to .001). Both groups demonstrated routine early chest compression and hyperventilation as evidenced by no significant difference in paramedic response time or rate of intubations. Initial emergency department blood gas results of both groups were not significantly different. No patients in the NO HCO3 group had hypernatremia (sodium [Na]+ greater than 150), whereas four patients (2%) in the HCO3 group were hypernatremic. Eight patients (14%) in the NO HCO3 group and 37 patients (17%) in the HCO3 group were alkalotic with pH values greater than 7.49 (P = NS). Six patients (10%) of the NO HCO3 group and 24 patients (11%) of the HCO3 group had a metabolic component to the alkalosis as defined by a positive base excess value (P = NS).(ABSTRACT TRUNCATED AT 250 WORDS)
T P Aufderheide; D R Martin; D W Olson; C Aprahamian; J W Woo; G E Hendley; K M Hargarten; B Thompson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of emergency medicine     Volume:  10     ISSN:  0735-6757     ISO Abbreviation:  Am J Emerg Med     Publication Date:  1992 Jan 
Date Detail:
Created Date:  1992-03-19     Completed Date:  1992-03-19     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8309942     Medline TA:  Am J Emerg Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  4-7     Citation Subset:  IM    
Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee.
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MeSH Terms
Acid-Base Equilibrium
Bicarbonates / administration & dosage,  therapeutic use*
Carbon Dioxide / blood
Data Interpretation, Statistical
Electrolytes / blood
Emergency Medical Services
Heart Arrest / blood,  drug therapy*,  mortality
Middle Aged
Oxygen / blood
Retrospective Studies
Survival Analysis
Reg. No./Substance:
0/Bicarbonates; 0/Electrolytes; 124-38-9/Carbon Dioxide; 7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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