Published online October 1, 2008
PEDIATRICS Vol. 122 No. 4 October 2008, pp. 831-835 (doi:10.1542/peds.2007-2400)
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SPECIAL ARTICLE

Sodium Bicarbonate: Basically Useless Therapy

Judy L. Aschner, MDa,b,c and Ronald L. Poland, MDd

a Department of Pediatrics
b Center for Molecular Toxicology
c Vanderbilt Kennedy Center for Research on Human Development, Vanderbilt University Medical Center, Nashville, Tennessee
d Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, New Mexico

Common clinical practices often are unsupported by experimental evidence. One example is the administration of sodium bicarbonate to neonates. Despite a long history of widespread use, objective evidence that administration of sodium bicarbonate improves outcomes for patients in cardiopulmonary arrest or with metabolic acidosis is lacking. Indeed, there is evidence that this therapy is detrimental. This review examines the history of sodium bicarbonate use in neonatology and the evidence that refutes the clinical practice of administering sodium bicarbonate during cardiopulmonary resuscitation or to treat metabolic acidosis in the NICU.

Key Words: sodium bicarbonate • metabolic acidosis • neonatal resuscitation • NICU • clinical practice

Abbreviations: CPR—cardiopulmonary resuscitation • RCT—randomized, controlled trial

Accepted Jan 7, 2008.


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