Reference: Clinical studies of sodium bicarbonate in the treatment of metabolic acidosis

Sodium bicarbonate may be used in patients with DKA because it corrects acidosis and reduces insulin resistance. But a single-center retrospective study found that sodium bicarbonate did not improve recovery time and did not affect length of hospital stay in patients with DKA with pH <7.0. A 2011 systematic analysis found that sodium bicarbonate did not shorten the time to acidosis, ketosis, and hyperglycemia. At the same time, sodium bicarbonate can cause hypokalemia. These studies have shown that the benefits of sodium bicarbonate in the treatment of DKA are not significant. But it's important to know that this RCT study lacks strong clinical trials to support its conclusions.

Can sodium bicarbonate improve the condition in patients with lactic acidosis? Cooper's study found that sodium bicarbonate was able to raise pH and PCO2, but there was no change in cardiac output and blood pressure. Similarly, Mathieu found that when sodium bicarbonate was transfused in patients with lactic acidosis, the pH of patients rose, but there was no improvement in hemodynamic indicators (including CI).

What is the outcome of sodium bicarbonate use in patients with cardiac arrest? Several studies have found that patients using sodium bicarbonate are more likely to return to autonomous circulation. But there are also studies that show that using sodium bicarbonate results in lower productivity and worse neurological prognosis for patients. One RCT study found that sodium bicarbonate did not improve productivity, spontaneous cycle recovery time, and neurological function in patients with cardiac arrest. For patients with cardiac arrest, sodium bicarbonate is not routinely recommended. （At present, routine use of sodium bicarbonate is not recommended for cardiopulmonary esuscitation）