Sodium bicarbonate therapy for patients with severe metabolic acidemia in the ICU

The BICAR-ICU clinical study was set up to investigate whether critically ill patients who develop acute metabolic acidemia receive clinical benefit from treatment with I.V. sodium bicarbonate. The sample population included qualifying adults admitted to 26 ICUs in France.

The BICAR-ICU clinical study was set up to investigate whether critically ill patients who develop acute metabolic acidemia receive clinical benefit from treatment with I.V. sodium bicarbonate. The sample population included qualifying adults admitted to 26 ICUs in France. Patients were evenly randomized to treatment or no treatment with sodium bicarbonate. The primary endpoint was a composite of all-cause mortality by day 28 and at least one organ failure at day 7, which occurred in 71% of the 194 patients in the control group. The same was true for 66% of the 195 patients in the bicarbonate arm. The odds of survival at day 28 was not considered statistically significant between the two treatment groups; however, it was meaningful when considering only the subgroup of patients with acute kidney damage.