| Title: |
Sodium Bicarbonate for Severe Metabolic Acidemia and Acute Kidney Injury |
| Authors: |
Jung, Boris; Jabaudon, Mathieu; de Jong, Audrey; Bitker, Laurent; Audard, Jules; Klouche, Kada; Sarton, Benjamine; Guitton, Christophe; Lasocki, Sigismond; Rieu, Benjamin; Canet, Emmanuel; Jeantrelle, Caroline; Roquilly, Antoine; Mayaux, Julien; Verdonk, Franck; Pottecher, Julien; Ferrandiere, Martine; Riu, Beatrice; Garcon, Pierre; Assefi, Mona; Detouche, Philippe; Forel, Jean Marie; Roger, Claire; Bourenne, Jeremy; Jacquier, Sophie; Bougon, David; Rolle, Amelie; Corne, Philippe; Benchabane, Nacim; Richard, Jean Christophe; Asehnoune, Karim; Chanques, Gerald; Reignier, Jean; Belafia, Foud; Fosset, Maxime; Huguet, Helena; Futier, Emmanuel; Molinari, Nicolas; Jaber, Samir; Machado, Sonia; Brunot, Vincent; Platon, Laura; Daubin, Delphine; Besnard, Noémie; Moulaire, Valérie; Pelle, Corinne; Landreau, Liliane; Deneil, Guillaume; Yonis, Hodane; Mezidi, Mehdi; Chauvelot, Louis; Silva, Stein; Tirot, Patrice; Darreau, Cedric; Chudeau, Nicolas; Campfort, Maeva; Gergaud, Soizic; Giordanetto, Loris; Godet, Thomas; Lascarrou, Jean Baptiste; Giabicani, Mikahel; Ashenoune, Karim; Hourmant, Yannick; Bourdiol, Alexre; Poulain, Cécile; Demoule, Alexre; Dres, Martin; Decavèle, Maxens; Lecronier, Marie; Bureau, Côme; Do Vale, Julien; Menat, Sophie; Clerc, Sebastien; Pichon, Jeremie; Catano, Jennifer; Celier, Adam; Le Stang, Valentine; Diemoz, Marie-Claire; Flis-Richard, Hugo; Pardo, Emmanuel; Kapandji, Natacha; Meyer, Alain; Hecketsweiler, Stephane; Selim Abback, Paer; Vong, Ly van Phach; Reitter, Delphine; Zarka, Jonathan; Constantin, Jean Michel; Daviet, Florence; Muller, Laurent; Lefrant, Jean Yves; Ehrmann, Stephan; Salmon Ginniere, Charlotte; Bodet Contentin, Laetitia; Carvelli, Julien; Gainier, Marc; Cholley, Bernard; Dellamonica, Jean; Jozwiak, Mathieu; Sacchieri, Clement; Lautrette, Alexandre; Cour, Martin; Argaud, Laurent; Rimmele, Thomas; Preau, Sebastien; Capdevila, Xavier; Fiancette, Maud; Roux, Damien; Bohe, Julien; Asfar, Pierre; Chabanne, Russel; Terzi, Nicolas; Bige, Naïke; Garnero, Aude; Mokart, Djamel; Kallel, Hatem |
| Contributors: |
Physiologie & médecine expérimentale du Cœur et des Muscles U 1046 (PhyMedExp); Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM); Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier); Centre Hospitalier Universitaire de Nîmes (CHU Nîmes) |
| Source: |
ISSN: 2380-6583. |
| Publisher Information: |
CCSD; American Medical Association |
| Publication Year: |
2025 |
| Collection: |
Université de Montpellier: HAL |
| Subject Terms: |
[SDV]Life Sciences [q-bio] |
| Description: |
International audience ; Importance The effect of sodium bicarbonate infusion on outcome in patients with severe metabolic acidemia and moderate to severe acute kidney injury is unknown. Objective To determine whether sodium bicarbonate infusion is associated with day 90 all-cause mortality in patients with severe metabolic acidemia and moderate to severe acute kidney injury. Design, Setting, and Participants Randomized, open-label, clinical trial conducted with 640 patients in 43 French intensive care units from October 6, 2019, to December 19, 2023, with 90-day follow-up. The last date of follow-up was June 17, 2024. Adults with severe metabolic acidemia (defined as pH ≤7.20) and moderate to severe acute kidney injury were enrolled. Intervention Patients were randomized 1:1 to receive either intravenous sodium bicarbonate infusion or no sodium bicarbonate to target an arterial pH of 7.30 or higher. Main Outcomes and Measures The primary outcome was day 90 all-cause mortality. Secondary outcomes included day 28 and day 180 all-cause mortality; use of organ support therapy, vasopressors, or invasive mechanical ventilation; intensive care unit and hospital length of stay; intensive care unit–acquired infections; fluid balance; day-7 Sequential [Sepsis-related] Organ Failure Assessment score (6 organ systems’ function is evaluated and scored from 0 [no dysfunction] to 4 [failure]; total score ranges from 0 [normal] to 24 [maximum failure]); and major adverse kidney events on day 90. Results Among 640 randomly assigned patients, 627 were analyzed (313 in the control group and 314 in the bicarbonate group). The median age was 67 years (IQR, 59-74 years); 194 of 314 patients (62%) in the bicarbonate group and 185 of 313 controls (59%) were male. In the primary analysis, day 90 all-cause mortality was 195 of 314 patients (62.1%) in the bicarbonate group and 193 of 313 (61.7%) in the control group (absolute difference, 0.4; 95% CI, −7.2 to 8.0; P = .91). There was no evidence of a group effect on day 28 or day 180 ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1001/jama.2025.20231 |
| Availability: |
https://hal.science/hal-05338215; https://hal.science/hal-05338215v1/document; https://hal.science/hal-05338215v1/file/2025%20Jung%20et%20al.pdf; https://doi.org/10.1001/jama.2025.20231 |
| Rights: |
https://about.hal.science/hal-authorisation-v1/ ; info:eu-repo/semantics/OpenAccess |
| Accession Number: |
edsbas.383E7005 |
| Database: |
BASE |