Sodium Bicarbonate for the Treatment of Severe Metabolic Acidosis With Moderate or Severe Acute Kidney Injury in ICU
Status:
Recruiting
Trial end date:
2023-10-01
Target enrollment:
Participant gender:
Summary
Severe metabolic acidemia in the critically ill (pH equal or less than 7.20; PaCO2 equal or
less than 45mmHg and bicarbonate concentration equal or less than of 20 mmol/l) is associated
with a 50% rate of day 28 mortality. Moderate to severe acute kidney injury is a frequent
cause of metabolic acidemia in the critically ill. When both severe metabolic acidemia and
moderate to severe acute kidney injury are observed, day 28 mortality is approximatively
55-60%. Severe acidemia has been shown to be a biomarker of severity but may also contribute
by itself to outcome. Investigators recently performed a multiple center randomised clinical
trial (BICARICU-1) that suggests that sodium bicarbonate infusion titrated to maintain the pH
equal or more than 7.30 is associated with a higher survival rate (secondary endpoint) in
patients presenting both severe metabolic acidemia and moderate to severe acute kidney injury
patients. Whether sodium bicarbonate infusion may improve long term survival (Day 90, primary
outcome) in these severe acute kidney injury patients is currently unknown.