Velissaris Dimitrios, Karamouzos Vassilios, Pierrakos Charalampos, Koniari Ioanna, Apostolopoulou Christina, Karanikolas Menelaos
Internal Medicine Department, University Hospital of Patras, Greece.
Intensive Care Department, Brugmann University Hospital, Brussels, Belgium.
J Clin Med Res. 2016 Apr;8(4):277-83. doi: 10.14740/jocmr2456w. Epub 2016 Feb 27.
The aim of the review was to summarize the literature over the last 25 years regarding bicarbonate administration in out-of-hospital cardiac arrest. A PubMed search was conducted using the terms "bicarbonates" and "cardiac arrest", limited to human studies and reviews published in English (or at least with a meaningful abstract in English) in the last 25 years. Clinical and experimental data raised questions regarding the safety and effectiveness of sodium bicarbonate (SB) administration during cardiac arrest. Earlier advanced cardiac life support (ACLS) guidelines recommended routine bicarbonate administration as part of the ACLS algorithm, but recent guidelines no longer recommend its use. The debate in the literature is ongoing, but at the present time, SB administration is only recommended for cardiac arrest related to hypokalemia or overdose of tricyclic antidepressants. Several studies challenge the assumption that bicarbonate administration is beneficial for treatment of acidosis in cardiac arrest. At the present time, there is a trend against using bicarbonates in cardiac arrest, and this trend is supported by guidelines published by professional societies and organizations.
本综述的目的是总结过去25年里有关院外心脏骤停时使用碳酸氢盐的文献。通过在PubMed上搜索“碳酸氢盐”和“心脏骤停”等术语，搜索范围限定为过去25年发表的英文人体研究和综述（或至少有英文摘要）。临床和实验数据对心脏骤停期间给予碳酸氢钠（SB）的安全性和有效性提出了疑问。早期的高级心脏生命支持（ACLS）指南推荐将常规给予碳酸氢盐作为ACLS流程的一部分，但最近的指南不再推荐使用。文献中的争论仍在继续，但目前，仅推荐在与低钾血症或三环类抗抑郁药过量相关的心脏骤停时使用SB。一些研究对给予碳酸氢盐有利于治疗心脏骤停时酸中毒这一假设提出了质疑。目前，存在反对在心脏骤停时使用碳酸氢盐的趋势，专业协会和组织发布的指南也支持这一趋势。
