The sodium bicarbonate controversy.

Sodium bicarbonate has been deleted from the advanced cardiac life support protocol. Sodium bicarbonate is no longer endorsed as the method of choice for the management of metabolic acidosis in the early rounds of cardiopulmonary resuscitation. This paper discusses mechanisms of acidosis occurring during cardiopulmonary arrest, past and present protocols for sodium bicarbonate administration and rationale for the deletion of sodium bicarbonate from resuscitation protocols.