Effects of acidemia and sodium bicarbonate therapy in advanced cardiac life support.

Cardiac output using the currently recommended closed-chest cardiopulmonary resuscitation (CPR) technique is marginal (less than 30% of control), and eventually will result in tissue hypoperfusion and lactic acidemia. Intermittent sodium bicarbonate administration currently is recommended for treatment of this metabolic acidemia, and based on available data recommended dosages are empiric but sound. In this review the potential complications of acidemia and sodium bicarbonate administration are considered from the viewpoint of resuscitation outcome. In our opinion, available data are limited, and further evaluation and consideration of sodium bicarbonate requirements in the resuscitation setting are required.