Sodium Bicarbonate in Cardiopulmonary Resuscitation
Status:
Unknown status
Trial end date:
2014-03-01
Target enrollment:
Participant gender:
Summary
Out-of-hospital cardiac arrests (OHCA) account for over 60% of deaths from coronary artery
disease. The annual incidence of OHCA treated by Emergency Medical Systems (EMS) is 41-89 per
100,000 population. Outcome of OHCA and cardiopulmonary resuscitation (CPR) is very poor:
Less than 1/3 of the victims regain spontaneous circulation (ROSC), 40-60% of those achieving
ROSC suffer significant neurological disability due to brain hypoxia and only 1.7-6.4% are
discharged from the hospital. In order to minimize hypoxia time, the primary goal of CPR is
to achieve return of spontaneous circulation (ROSC) as fast as possible. Metabolic (lactic)
acidosis develops rapidly during CA and is considered detrimental to CPR outcome. Sodium
bicarbonate (SB), a generic, commonly used acid buffer, was subjected only to a single,
small, prospective controlled trial that found a trend towards improved outcome in prolonged
OHCA and CPR. Another study indicated that EMS's that used SB early and often during CPR had
significantly higher ROSC rates and better long-term outcome compared with EMS's that used SB
more seldom and administered it late in the course of CPR.
Aim of the Study:
To determine whether early administration of SB during OHCA and CPR improves short-term CPR
outcome.