Effectiveness of Sodium Bicarbonate Administration in Out-of-Hospital Cardiac Arrests: An Updated Systematic Review and Meta-Analysis
Bibliographic record
Abstract
OBJECTIVES: The use of sodium bicarbonate (SB) in the treatment of cardiac arrest without known etiology is still controversial and is not routinely recommended by the American Heart Association guidelines. This study summarizes current evidence on the use of SB in out-of-hospital cardiac arrest (OHCA). METHODS: We systematically searched PubMed, Scopus, and Cochrane databases for randomized controlled trials (RCTs) and observational studies evaluating SB in OHCA. Return of spontaneous circulation (ROSC) was the primary outcome, explicitly defined as the return of a palpable pulse and measurable blood pressure; sustained ROSC (≥20 min) was noted separately. Survival to discharge was a secondary outcome. Using a random-effects model, we pooled Odds Ratios (OR) for binary outcomes with 95% confidence intervals (CI). RESULTS: = 0.48). CONCLUSIONS: Administration of sodium bicarbonate in patients with OHCA was not associated with improved ROSC or survival to discharge. Therefore, its routine use cannot be recommended. However, our review does not exclude the possibility of benefit in selected, guideline-specified contexts such as hyperkalemia or tricyclic antidepressant overdose, or when administered early during resuscitation. Further high-quality studies with standardized reporting of etiology, timing, dose, and airway management are needed to clarify these potential indications.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".