September 10, 2018

During a busy resuscitation it behooves the ED resuscitationist to avoid ordering therapies that have no clear benefit to their patients. Our nurses are overburdened, and adding interventions ‘just to be safe’ or ‘because we always do it’ is a great way to overwhelm our nursing colleagues. Bicarb administration is a contentious issue and many clinicians consider its use to fall firmly into the no-benefit camp, even when used in the management of severe metabolic acidosis. There have been no studies to date evaluating clinical outcomes  with the use of  sodium bicarbonate infusion therapy for severe metabolic acidemia, until now.  This post is a review of the recently published BICAR-ICU trial