The Efficacy and Safety of Sodium Bicarbonate Ringer’s Solution in Critically Ill Patients: A Retrospective Cohort Study
Background: Sodium bicarbonate Ringer’s solution has been widely used in clinical practice in recent years. There are few clinical studies on the efficacy and safety of this fluid among critically ill patients until now.Method: This retrospective cohort study included critically ill adult patients i...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-03-01
|
| Series: | Frontiers in Pharmacology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2022.829394/full |
| _version_ | 1811260618804559872 |
|---|---|
| author | Yi Bian Yi Bian Tingting Xu Tingting Xu Yue Le Yue Le Shusheng Li Shusheng Li |
| author_facet | Yi Bian Yi Bian Tingting Xu Tingting Xu Yue Le Yue Le Shusheng Li Shusheng Li |
| author_sort | Yi Bian |
| collection | DOAJ |
| description | Background: Sodium bicarbonate Ringer’s solution has been widely used in clinical practice in recent years. There are few clinical studies on the efficacy and safety of this fluid among critically ill patients until now.Method: This retrospective cohort study included critically ill adult patients in the intensive care unit (ICU) of Tongji Hospital from 1 January 2019 to 31 December 2020. By reviewing exclusively the use of either sodium bicarbonate Ringer’s solution or saline for resuscitation or maintenance, the patients were included into two groups, respectively. The primary outcome was the major adverse kidney event within 30 days (MAKE30), including death, new receipt of renal replacement therapy, or persistent renal dysfunction. Safety outcomes were focused on arterial blood gas and plasma biochemical alterations, which might potentially be induced by the administration of bicarbonate Ringer’s solution.Result: A total of 662 patients were included in the cohort. Compared to the saline group, the bicarbonate Ringer’s group had a significantly lower rate of the new receipt of renal replacement therapy [adjusted odds ratio (OR) = 0.591, 95% confidence interval (CI), 0.406 to 0.861; p = 0.006]. There was no significant difference between the two groups in 30-day mortality, final creatinine level ≥200% of baseline, and major adverse kidney event within 30 days. In subgroup analysis, the incidence of MAKE30 was higher in the bicarbonate Ringer’s group than that of the saline group among patients with cardiovascular disease. The patients in the bicarbonate Ringer’s group had a longer length of intensive care unit stay than patients in the saline group, but their new renal replacement therapy days were shorter. No major alterations were found in arterial blood gas and plasma biochemical during the follow-up period.Conclusion: Compared to saline, sodium bicarbonate Ringer’s solution exhibited a potential renal function protective effect while causing no major alterations in arterial blood gas and plasma biochemistry. However, the application in patients with cardiovascular disease diagnosis at ICU admission should be cautious. |
| first_indexed | 2024-04-12T18:50:05Z |
| format | Article |
| id | doaj.art-5a4b48d123854f22887536d70e7e35ff |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-04-12T18:50:05Z |
| publishDate | 2022-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-5a4b48d123854f22887536d70e7e35ff2022-12-22T03:20:30ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122022-03-011310.3389/fphar.2022.829394829394The Efficacy and Safety of Sodium Bicarbonate Ringer’s Solution in Critically Ill Patients: A Retrospective Cohort StudyYi Bian0Yi Bian1Tingting Xu2Tingting Xu3Yue Le4Yue Le5Shusheng Li6Shusheng Li7Department of Emergency Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Emergency Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Emergency Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Emergency Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaBackground: Sodium bicarbonate Ringer’s solution has been widely used in clinical practice in recent years. There are few clinical studies on the efficacy and safety of this fluid among critically ill patients until now.Method: This retrospective cohort study included critically ill adult patients in the intensive care unit (ICU) of Tongji Hospital from 1 January 2019 to 31 December 2020. By reviewing exclusively the use of either sodium bicarbonate Ringer’s solution or saline for resuscitation or maintenance, the patients were included into two groups, respectively. The primary outcome was the major adverse kidney event within 30 days (MAKE30), including death, new receipt of renal replacement therapy, or persistent renal dysfunction. Safety outcomes were focused on arterial blood gas and plasma biochemical alterations, which might potentially be induced by the administration of bicarbonate Ringer’s solution.Result: A total of 662 patients were included in the cohort. Compared to the saline group, the bicarbonate Ringer’s group had a significantly lower rate of the new receipt of renal replacement therapy [adjusted odds ratio (OR) = 0.591, 95% confidence interval (CI), 0.406 to 0.861; p = 0.006]. There was no significant difference between the two groups in 30-day mortality, final creatinine level ≥200% of baseline, and major adverse kidney event within 30 days. In subgroup analysis, the incidence of MAKE30 was higher in the bicarbonate Ringer’s group than that of the saline group among patients with cardiovascular disease. The patients in the bicarbonate Ringer’s group had a longer length of intensive care unit stay than patients in the saline group, but their new renal replacement therapy days were shorter. No major alterations were found in arterial blood gas and plasma biochemical during the follow-up period.Conclusion: Compared to saline, sodium bicarbonate Ringer’s solution exhibited a potential renal function protective effect while causing no major alterations in arterial blood gas and plasma biochemistry. However, the application in patients with cardiovascular disease diagnosis at ICU admission should be cautious.https://www.frontiersin.org/articles/10.3389/fphar.2022.829394/fullsodium bicarbonate Ringer’s solutionsalinecritically ill patientsoutcomesafety |
| spellingShingle | Yi Bian Yi Bian Tingting Xu Tingting Xu Yue Le Yue Le Shusheng Li Shusheng Li The Efficacy and Safety of Sodium Bicarbonate Ringer’s Solution in Critically Ill Patients: A Retrospective Cohort Study Frontiers in Pharmacology sodium bicarbonate Ringer’s solution saline critically ill patients outcome safety |
| title | The Efficacy and Safety of Sodium Bicarbonate Ringer’s Solution in Critically Ill Patients: A Retrospective Cohort Study |
| title_full | The Efficacy and Safety of Sodium Bicarbonate Ringer’s Solution in Critically Ill Patients: A Retrospective Cohort Study |
| title_fullStr | The Efficacy and Safety of Sodium Bicarbonate Ringer’s Solution in Critically Ill Patients: A Retrospective Cohort Study |
| title_full_unstemmed | The Efficacy and Safety of Sodium Bicarbonate Ringer’s Solution in Critically Ill Patients: A Retrospective Cohort Study |
| title_short | The Efficacy and Safety of Sodium Bicarbonate Ringer’s Solution in Critically Ill Patients: A Retrospective Cohort Study |
| title_sort | efficacy and safety of sodium bicarbonate ringer s solution in critically ill patients a retrospective cohort study |
| topic | sodium bicarbonate Ringer’s solution saline critically ill patients outcome safety |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2022.829394/full |
| work_keys_str_mv | AT yibian theefficacyandsafetyofsodiumbicarbonateringerssolutionincriticallyillpatientsaretrospectivecohortstudy AT yibian theefficacyandsafetyofsodiumbicarbonateringerssolutionincriticallyillpatientsaretrospectivecohortstudy AT tingtingxu theefficacyandsafetyofsodiumbicarbonateringerssolutionincriticallyillpatientsaretrospectivecohortstudy AT tingtingxu theefficacyandsafetyofsodiumbicarbonateringerssolutionincriticallyillpatientsaretrospectivecohortstudy AT yuele theefficacyandsafetyofsodiumbicarbonateringerssolutionincriticallyillpatientsaretrospectivecohortstudy AT yuele theefficacyandsafetyofsodiumbicarbonateringerssolutionincriticallyillpatientsaretrospectivecohortstudy AT shushengli theefficacyandsafetyofsodiumbicarbonateringerssolutionincriticallyillpatientsaretrospectivecohortstudy AT shushengli theefficacyandsafetyofsodiumbicarbonateringerssolutionincriticallyillpatientsaretrospectivecohortstudy AT yibian efficacyandsafetyofsodiumbicarbonateringerssolutionincriticallyillpatientsaretrospectivecohortstudy AT yibian efficacyandsafetyofsodiumbicarbonateringerssolutionincriticallyillpatientsaretrospectivecohortstudy AT tingtingxu efficacyandsafetyofsodiumbicarbonateringerssolutionincriticallyillpatientsaretrospectivecohortstudy AT tingtingxu efficacyandsafetyofsodiumbicarbonateringerssolutionincriticallyillpatientsaretrospectivecohortstudy AT yuele efficacyandsafetyofsodiumbicarbonateringerssolutionincriticallyillpatientsaretrospectivecohortstudy AT yuele efficacyandsafetyofsodiumbicarbonateringerssolutionincriticallyillpatientsaretrospectivecohortstudy AT shushengli efficacyandsafetyofsodiumbicarbonateringerssolutionincriticallyillpatientsaretrospectivecohortstudy AT shushengli efficacyandsafetyofsodiumbicarbonateringerssolutionincriticallyillpatientsaretrospectivecohortstudy |