using sodium bicarbonate during prolonged cardiopulmonary resuscitation in prehospital setting; a retrospective cross-sectional study

Introduction: although the 2020 american heart association (aha) guidelines recommend that sodium bicarbonate (sb) be avoided during routine cardiopulmonary resuscitation (cpr) a limited number of studies have examined the effects of sb injection during prolonged cpr (>15 min) in prehospital setting. the present study aimed to examine the effects of prehospital sb use during prolonged cpr on patients’ outcome. methods: in this retrospective cross-sectional study adult patients aged >18 years who experienced a non-traumatic, out-of-hospital cardiac arrest (ohca) were compared regarding three outcomes, namely return of spontaneous circulation (rosc), rosc > 20 minute, and survival to discharge, based on receiving or not-receiving sb during cpr. results: 330 patients were divided into two equal groups of 165. the two groups had similar conditions regarding gender distribution (p = 0.729); mean age (p = 0.741); underlying diseases (p = 0.027); etiology of arrest (p = 0.135); the initial rhythm (p = 0.324); receiving normal saline solution (p = 1.000), epinephrine (p = 0.848), and atropine during cpr (p = 0.054); and using defibrillation (p = 0.324). those who received sb had 0.80 times greater likelihood for sustained rosc (adjusted odds ratio (or) = 0.80, 95% ci: 0.47–1.37, p = 0.415), 0.93 times greater likelihood for rosc at the scene (adjusted or = 0.93, 95% ci: 0.55–1.59, p = 0.798), and 0.34 times greater likelihood for survival to discharge (adjusted or = 0.34, 95% ci: 0.10–1.17, p = 0.087). conclusions: the present study demonstrated that prehospital sb use by ems during prolonged cpr did not improve rosc rate at the scene, sustained rosc, and survival to discharge.