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Crit Care Res Pract. 2015;2015:605830. doi: 10.1155/2015/605830. Epub 2015 Jul 30.

The Use of Sodium Bicarbonate in the Treatment of Acidosis in Sepsis: A Literature Update on a Long Term Debate.

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Internal Medicine Department, University Hospital of Patras, 26500 Rion, Greece.
Internal Medicine Department, University Hospital of Patras, 26500 Rion, Greece ; University of Patras School of Medicine, 26500 Rion, Greece.
Intensive Care Department, Brugmann University Hospital, 1030 Brussels, Belgium.
Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO 63110, USA.



Sepsis and its consequences such as metabolic acidosis are resulting in increased mortality. Although correction of metabolic acidosis with sodium bicarbonate seems a reasonable approach, there is ongoing debate regarding the role of bicarbonates as a therapeutic option.


We conducted a PubMed literature search in order to identify published literature related to the effects of sodium bicarbonate treatment on metabolic acidosis due to sepsis. The search included all articles published in English in the last 35 years.


There is ongoing debate regarding the use of bicarbonates for the treatment of acidosis in sepsis, but there is a trend towards not using bicarbonate in sepsis patients with arterial blood gas pH > 7.15.


Routine use of bicarbonate for treatment of severe acidemia and lactic acidosis due to sepsis is subject of controversy, and current opinion does not favor routine use of bicarbonates. However, available evidence is inconclusive, and more studies are required to determine the potential benefit, if any, of bicarbonate therapy in the sepsis patient with acidosis.

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