Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/11333
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dc.contributor.authorChua, Horng Rueyen
dc.contributor.authorSchneider, Antoine Gen
dc.contributor.authorBellomo, Rinaldoen
dc.date.accessioned2015-05-16T00:55:23Z-
dc.date.available2015-05-16T00:55:23Z-
dc.date.issued2011-07-06en
dc.identifier.citationAnnals of Intensive Care 2011; 1(1): 23en
dc.identifier.govdoc21906367en
dc.identifier.otherPUBMEDen
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/11333en
dc.description.abstractThis study was designed to examine the efficacy and risk of bicarbonate administration in the emergent treatment of severe acidemia in diabetic ketoacidosis (DKA).PUBMED database was used to identify potentially relevant articles in the pediatric and adult DKA populations. DKA intervention studies on bicarbonate administration versus no bicarbonate in the emergent therapy, acid-base studies, studies on risk association with cerebral edema, and related case reports, were selected for review. Two reviewers independently conducted data extraction and assessed the citation relevance for inclusion.From 508 potentially relevant articles, 44 were included in the systematic review, including three adult randomized controlled trials (RCT) on bicarbonate administration versus no bicarbonate in DKA. We observed a marked heterogeneity in pH threshold, concentration, amount, and timing for bicarbonate administration in various studies. Two RCTs demonstrated transient improvement in metabolic acidosis with bicarbonate treatment within the initial 2 hours. There was no evidence of improved glycemic control or clinical efficacy. There was retrospective evidence of increased risk for cerebral edema and prolonged hospitalization in children who received bicarbonate, and weak evidence of transient paradoxical worsening of ketosis, and increased need for potassium supplementation. No studies involved patients with an initial pH < 6.85.The evidence to date does not justify the administration of bicarbonate for the emergent treatment of DKA, especially in the pediatric population, in view of possible clinical harm and lack of sustained benefits.en
dc.language.isoenen
dc.titleBicarbonate in diabetic ketoacidosis - a systematic review.en
dc.typeJournal Articleen
dc.identifier.journaltitleAnnals of intensive careen
dc.identifier.affiliationDepartment of Intensive Care, Austin Health, Heidelberg, Victoria, Australiaen
dc.identifier.doi10.1186/2110-5820-1-23en
dc.description.pages23en
dc.relation.urlhttps://pubmed.ncbi.nlm.nih.gov/21906367en
dc.type.austinJournal Articleen
local.name.researcherBellomo, Rinaldo
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.cerifentitytypePublications-
item.fulltextWith Fulltext-
item.grantfulltextopen-
item.languageiso639-1en-
item.openairetypeJournal Article-
crisitem.author.deptIntensive Care-
crisitem.author.deptData Analytics Research and Evaluation (DARE) Centre-
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