Treating In-Hospital Cardiac Arrest With Sodium Bicarbonate—Reply
https://jamanetwork.com/journals/jama/fullarticle/2854748
In Reply In their letter about our recent BIHCA trial, Dr Gelbenegger and colleagues focus on the numerical differences in 30-day survival (12% vs 9.1%) and 30-day favorable neurological outcome (8.1% vs 5.4%) between groups. As noted, the trial was not powered for these outcomes and the results are uncertain. The 95% CIs for the risk ratio for 30-day survival ranged from 0.84 to 1.88 and for 30-day favorable neurological outcome from 0.82 to 2.34. As such, our results were compatible with harm, no effect, and benefit. Until well-conducted and sufficiently powered randomized clinical trials establish a benefit of sodium bicarbonate during cardiac arrest, consistent with international guidelines, we do not believe it should be administered routinely.
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