View source for EBQ:Sodium Bicarbonate use in DKA

==Clinical Question==
Should Sodium Bicarbonate be used to treat Diabetic Ketoacidosis ?

==Background==
Sodium bicarbonate is a solution which help alkalanizing the blood by binding the H<sup>+</sup> and converting it to water and Co<sub>2</sub>. Many Physicians use it to treat DKA, but based on what ? Is there any evidence supporting its use ?

==Pro Argument==

===Trial 1===

===Trial 2===

===Trial 3===

==Con Argument==
===Trial 1===
'''21 patients''' underwent RCT
* 10 patients (PH 6.9-7.14) received NaHco<sub>3</sub>
* 11 patients in the control group
'''Results:''' No differences in Glucose level, bicarb level nor PH <ref>Ann Intern Med. 1986 Dec;105(6):836-40</ref>

===Trial 2===
Prospective, Randomized, Blinded and cross over study included '''14 patients'''
* HCO<sub>3</sub> level <17
* Received Sodium Bicarbonate 2mmol/kg over 15 minutes 
'''Results:''' Sodium Bicarbonate decreased Ionized Calcium, increased Paco<sub>2</sub> and didn't improve hemodynamics<ref>Ann Intern Med. 1990 Apr 1;112(7):492-8</ref>

===Trial 3===
Review Article included patients with PH<7 
* '''Results:''' Sodium Bicarbonate didn't decrease time to improvement nor to hospital discharge<ref>[http://www.ncbi.nlm.nih.gov/pubmed/23737516 Ann Pharmacother. 2013 Jul-Aug;47(7-8):970-5]</ref>

==Sources==
<references/>
http://saudiemergencymedicine.com/should-you-use-sodium-bicarbonate-in-acidosis-stop-for-a-minute/
[[Category:EBQ]]