Effectiveness of Sodium Bicarbonate Infusion on Mortality in Critically Ill Children With Metabolic Acidosis
Objective: Metabolic acidosis often occurs in the paediatric intensive care unit (PICU). Although sodium bicarbonate (SB) has been widely used in paediatrics, data on the effect of SB on children with metabolic acidosis in the PICU are scarce.Methods: Patients with metabolic acidosis who were treate...
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| Format: | Article |
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Frontiers Media S.A.
2022-03-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2022.759247/full |
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| author | Huabin Wang Huabin Wang Rui Liang Tianqi Liang Tianqi Liang Songyao Chen Yulong Zhang Lidan Zhang Lidan Zhang Chun Chen Chun Chen |
| author_facet | Huabin Wang Huabin Wang Rui Liang Tianqi Liang Tianqi Liang Songyao Chen Yulong Zhang Lidan Zhang Lidan Zhang Chun Chen Chun Chen |
| author_sort | Huabin Wang |
| collection | DOAJ |
| description | Objective: Metabolic acidosis often occurs in the paediatric intensive care unit (PICU). Although sodium bicarbonate (SB) has been widely used in paediatrics, data on the effect of SB on children with metabolic acidosis in the PICU are scarce.Methods: Patients with metabolic acidosis who were treated with SB within 48 h of PICU admission were screened. Multivariate logistic regression, subgroup analysis, and propensity score matching (PSM) were used to investigate the relationships between SB infusion and clinical outcomes.Results: A total of 1,595 patients with metabolic acidosis were enrolled in this study. In the multivariate logistic regression model, SB infusion was not correlated with in-hospital mortality (odds ratio (OR) 0.87, 95% confidence interval (CI) 0.47–1.63, p = 0.668), but was significantly correlated with hypernatraemia (OR 1.98, 95% CI 1.14–3.46, p = 0.016), hypokalaemia (OR 2.01, 95% CI 1.36–2.96, p < 0.001), and hypocalcaemia (OR 4.29, 95% CI 2.92–6.31, p < 0.001). In the pH value, lactate level, acute kidney injury level, age grouping, and anion gap level subgroups, the ORs for SB and in-hospital mortality were not statistically significant. After PSM, the results remained unchanged.Conclusion: SB infusion does not reduce the in-hospital mortality of severely ill children with metabolic acidosis and increases the risk of hypernatraemia, hypokalaemia, and hypocalcaemia. More effort should be focused on eliminating the causes of metabolic acidosis rather than SB infusion. |
| first_indexed | 2024-12-13T06:51:00Z |
| format | Article |
| id | doaj.art-2d0251dea01147cb8a34cdcc2cba6e48 |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-12-13T06:51:00Z |
| publishDate | 2022-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-2d0251dea01147cb8a34cdcc2cba6e482022-12-21T23:56:09ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122022-03-011310.3389/fphar.2022.759247759247Effectiveness of Sodium Bicarbonate Infusion on Mortality in Critically Ill Children With Metabolic AcidosisHuabin Wang0Huabin Wang1Rui Liang2Tianqi Liang3Tianqi Liang4Songyao Chen5Yulong Zhang6Lidan Zhang7Lidan Zhang8Chun Chen9Chun Chen10Division of Hematology/Oncology, Department of Pediatrics, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, ChinaDepartment of Pediatric Intensive Care Unit, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, ChinaDepartment of Colorectal Surgery, The Third Affiliated Hospital of Kunming Medical University, Kunming, ChinaDivision of Hematology/Oncology, Department of Pediatrics, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, ChinaDepartment of Pediatric Intensive Care Unit, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, ChinaCenter of Digestive Disease, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, ChinaScientific Research Center, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, ChinaDivision of Hematology/Oncology, Department of Pediatrics, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, ChinaDepartment of Pediatric Intensive Care Unit, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, ChinaDivision of Hematology/Oncology, Department of Pediatrics, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, ChinaDepartment of Pediatric Intensive Care Unit, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, ChinaObjective: Metabolic acidosis often occurs in the paediatric intensive care unit (PICU). Although sodium bicarbonate (SB) has been widely used in paediatrics, data on the effect of SB on children with metabolic acidosis in the PICU are scarce.Methods: Patients with metabolic acidosis who were treated with SB within 48 h of PICU admission were screened. Multivariate logistic regression, subgroup analysis, and propensity score matching (PSM) were used to investigate the relationships between SB infusion and clinical outcomes.Results: A total of 1,595 patients with metabolic acidosis were enrolled in this study. In the multivariate logistic regression model, SB infusion was not correlated with in-hospital mortality (odds ratio (OR) 0.87, 95% confidence interval (CI) 0.47–1.63, p = 0.668), but was significantly correlated with hypernatraemia (OR 1.98, 95% CI 1.14–3.46, p = 0.016), hypokalaemia (OR 2.01, 95% CI 1.36–2.96, p < 0.001), and hypocalcaemia (OR 4.29, 95% CI 2.92–6.31, p < 0.001). In the pH value, lactate level, acute kidney injury level, age grouping, and anion gap level subgroups, the ORs for SB and in-hospital mortality were not statistically significant. After PSM, the results remained unchanged.Conclusion: SB infusion does not reduce the in-hospital mortality of severely ill children with metabolic acidosis and increases the risk of hypernatraemia, hypokalaemia, and hypocalcaemia. More effort should be focused on eliminating the causes of metabolic acidosis rather than SB infusion.https://www.frontiersin.org/articles/10.3389/fphar.2022.759247/fullsodium bicarbonatepediatric intensive care unitmetabolic acidosisprognostic valuecohort study |
| spellingShingle | Huabin Wang Huabin Wang Rui Liang Tianqi Liang Tianqi Liang Songyao Chen Yulong Zhang Lidan Zhang Lidan Zhang Chun Chen Chun Chen Effectiveness of Sodium Bicarbonate Infusion on Mortality in Critically Ill Children With Metabolic Acidosis Frontiers in Pharmacology sodium bicarbonate pediatric intensive care unit metabolic acidosis prognostic value cohort study |
| title | Effectiveness of Sodium Bicarbonate Infusion on Mortality in Critically Ill Children With Metabolic Acidosis |
| title_full | Effectiveness of Sodium Bicarbonate Infusion on Mortality in Critically Ill Children With Metabolic Acidosis |
| title_fullStr | Effectiveness of Sodium Bicarbonate Infusion on Mortality in Critically Ill Children With Metabolic Acidosis |
| title_full_unstemmed | Effectiveness of Sodium Bicarbonate Infusion on Mortality in Critically Ill Children With Metabolic Acidosis |
| title_short | Effectiveness of Sodium Bicarbonate Infusion on Mortality in Critically Ill Children With Metabolic Acidosis |
| title_sort | effectiveness of sodium bicarbonate infusion on mortality in critically ill children with metabolic acidosis |
| topic | sodium bicarbonate pediatric intensive care unit metabolic acidosis prognostic value cohort study |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2022.759247/full |
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