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Acute kidney damage is a common problem that is often found in people who need treatment for problems not related to kidney health. Failing kidney health often causes more acid than normal in the blood (acidosis), which in itself is thought to cause harm.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

Intravenous infusion of sodium bicarbonate to newborn babies during resuscitation in the delivery room at birth. At birth some babies who do not start breathing spontaneously have an abnormal amount of acid in their blood. To treat this, an alkaline drug, sodium bicarbonate, has often been given intravenously. Although this has been common practice for over thirty years, there is no good evidence that this is beneficial and may cause harm. We found only one high quality study of 55 babies that compared sodium bicarbonate treatment with no treatment. The study did not show any benefit of the use of this drug immediately after birth, nor any adverse effects.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Many people, particularly in developing countries, are poisoned by organophosphorus pesticides (OPs) used in agriculture or for killing insects in the home. Poisoning may be accidental or intentional. Even when the usual antidotes are given, 10 to 20% of those poisoned still die. Research in animals has suggested that use of sodium bicarbonate (baking soda) or similar chemicals which make the blood alkaline might save people poisoned by OPs.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Sick preterm infants are easily affected by reduced oxygen levels, cold and poor blood circulation. Their blood becomes acid with a build up of lactic acid (metabolic acidosis) that their kidneys cannot correct. Metabolic acidosis in preterm infants may cause bleeding in the brain (intra or periventricular haemorrhage) and problems with longer‐term neurodevelopment (including hearing, vision and cognitive ability). Solutions of the alkaline sodium bicarbonate or tris‐(hydroxymethyl) amino methane (THAM) can be given to correct the acidity. These solutions are more concentrated than blood (hyperosmolar), which can change blood flow and cause bleeding in the brain, especially when given rapidly or in large quantities. The rationale for their use is to prevent the adverse outcomes that are associated with acidosis in preterm infants.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

In health, protein and amino acids remain in equilibrium however in CKD this balance is disturbed. Metabolic acidosis has been shown to have deleterious effects on protein balance, leading to a negative nitrogen balance, increased protein degradation, increased essential amino acid oxidation, reduced albumin synthesis and a lack of adaption to a low protein diet, and hence is associated with protein energy malnutrition, loss of lean body mass and muscle weakness. Metabolic acidosis is also a factor in the development of renal bone disease, as bone acts as a buffer for excess acid, with loss of mineral resulting from the increase in acid. This review found three small trials in adult haemodialysis patients (n = 117). The evidence for the benefits and risks of correcting metabolic acidosis is very limited with no RCTs in pre‐ESRD patients and none in children. These trials suggest there may be some beneficial effects on both protein and bone metabolism but the trials were underpowered to provide strong evidence.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Plain language summary will be included with future update.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Current medicines (e.g. Gaviscon Infant®) aim to thicken stomach contents, neutralise stomach acid (ranitidine, omeprazole, lansoprazole) or help the stomach to empty faster (domperidone). We looked at all available studies to try to find out whether any of the medicines currently used for reflux can help babies and children. We wanted to know whether these medicines make babies and children feel better, or whether test results (such as healing of the lining of the oesophagus, assessed through endoscopy (a small camera passed down the food pipe), or lowering of the amount of acidity in the oesophagus, assessed using a pH probe over 24 hours) get better when these medicines are given.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

The pancreas is located in the upper abdomen behind the stomach. It plays a major role in digestion and in controlling sugar metabolism by producing enzymes and hormones like insulin.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: December 30, 2016

If a child wets the bed, parents often ask themselves what they might have done wrong. But bedwetting is usually not anyone’s “fault,” and it will stop on its own sooner or later. Knowing that can be comforting, for the child too. Taking a deep breath and following practical approaches can help make it easier to cope with these nighttime accidents.Treatment is a good idea if the bedwetting is causing problems for the family or has become an emotional burden. But taking some practical steps can also make dealing with bedwetting easier for everyone involved.For instance, a nightlight or an easy-to-reach light switch in the hallway or bathroom can help the child reach the toilet quickly. Keeping a potty next to the bed might be an option if the child has difficulty making it in time. If the child’s room is not near the toilet, it might be worth considering switching rooms, if possible.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: February 6, 2014

Acute poisoning with chlorophenoxy herbicides such as 2,4‐D and MCPA is reported world wide, potentially causing severe toxicity and death. Since there is no antidote for chlorophenoxy herbicides, treatments such as urinary alkalinisation have been used to increase the clearance of these poisons from the body. Although urinary alkalinisation was first trialled over 30 years ago, it is not currently used routinely for the treatment of patients with acute chlorophenoxy poisoning. This review looked for studies where this treatment had been given to poisoned patients. No studies of sufficient quality were identified and therefore routine use of this approach to treatment cannot be recommended. However, due to the poor outcomes in patients who present with severe toxicity it may have a role in addition to standard intensive care support. More research should be conducted.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Impacted ear wax is one of the most common reasons that people visit their general practitioners (family doctors) with ear problems, as it can cause reduced hearing, discomfort, and sometimes pain and dizziness. Ear drops (either oil‐ or water‐based) are often prescribed to clear the wax or to aid subsequent ear syringing if necessary. The review of trials found that ear drops (of any sort) can help to remove ear wax, but that water and saline drops appear to be as good as more costly commercial products. The quality of the trials was generally low, however, and more research is needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

The kidneys may be damaged during an operation as a result of direct and indirect insult. The reasons for this are multiple and include changes to physiology brought on by the surgery and by the body’s response to such insult. Damage to kidneys during the perioperative period is associated with significant morbidity and mortality. This updated Cochrane review looked at 72 randomized controlled trials (RCTs) with 4378 participants (search data until August 2012); interventions most often included pharmacological interventions (administration of dopamine and its analogues, diuretics, calcium channel blockers, angiotensin‐converting enzyme (ACE) inhibitors, N‐acetyl cysteine, atrial natriuretic peptide, sodium bicarbonate, antioxidants and erythropoietin) or selected hydration fluids. We attempted to identify any possible damage to the kidneys by evaluating kidney function up to seven days after the operation.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

We searched for all studies that tested whether therapies were effective and safe at treating high potassium published up to 18 August 2015. We found seven studies that investigated drug therapies for treating hyperkalaemia in adults which together included results from 241 participants. Most studies tested the therapies in male and female adults with kidney problems who were medically stable. We did not find any studies that looked at the serious medical complications of high potassium such as death.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Cardenolides are naturally occurring plant toxins which act primarily on the heart. While poisoning with the digitalis cardenolides (digoxin and digitoxin) are reported worldwide, cardiotoxicity from other cardenolides such as the yellow oleander are also a major problem, with tens of thousands of cases of poisoning each year in South Asia. Because cardenolides from these plants are structurally similar, acute poisonings are managed using similar treatments. The benefit of these treatments is of interest, particularly in the context of cost since most poisonings occur in developing countries where resources are very limited. The objectives of this review are to determine the efficacy of antidotes for the treatment of acute cardenolide poisoning, in particular atropine, isoprenaline (isoproterenol), multiple‐dose activated charcoal (MDAC), fructose‐1,6‐diphosphate, sodium bicarbonate, magnesium, phenytoin and antidigoxin Fab antitoxin.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

How do proton pump inhibitors compare in gastroesophageal reflux disease (GERD)?

PubMed Clinical Q&A [Internet] - National Center for Biotechnology Information (US).

Version: October 1, 2010

A central venous catheter is a small, hollow tube that is inserted into a large vein in either the chest, neck or groin. Central venous catheters enable healthcare professionals to administer drugs and other fluids directly into the blood stream, in order to treat critically ill patients or those patients with a long‐term condition. In certain chronic conditions, patients or their carers may also be involved with the administration of treatment interventions via the central venous catheter.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

We reviewed the evidence for using drugs to reduce stomach acid in people with cystic fibrosis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Treatment for CIN is usually undertaken in an outpatient colposcopy clinic to remove the pre‐cancerous cells from the cervix (lower part of the womb). It commonly involves lifting the cells off the cervix with electrically heated wire (diathermy) or laser, or destroying the abnormal cells with freezing methods (cryotherapy). This is potentially a painful procedure.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Elevated levels of potassium (an important salt for normal body functions) are common in infants born very preterm or with birth weight less than 1500 g. High potassium levels in the blood may lead to irregular or rapid heart rate that may result in bleedings in the brain and/or sudden death. The objective of this review was to determine the effectiveness and safety of interventions for this serious condition. Two studies enrolling 52 infants that assessed the use of a combination of insulin and sugar to reduce the blood levels of potassium were identified. This combination reduced the duration of high blood levels of potassium and the risk for bleeds in the brains of the infants. One study that enrolled 19 patients reported on the use of albuterol (a medication that helps to move potassium from the blood to the body cells). Albuterol lowered the blood levels of potassium both at four and at eight hours after the treatment had started. Because of the few infants enrolled in the studies to date, no firm recommendations for the treatment of too high blood levels of potassium in neonates can be made. Further research is needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

To review evidence from randomized controlled trials on safety and effects of administration of buffered versus non‐buffered fluids into the veins of adult patients undergoing surgery.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: September 21, 2017

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