Will the Bicarbonate for In-Hospital Cardiac Arrest Trial Change Practice?

In this issue of JAMA, Granfeldt and colleagues share results of the Bicarbonate for In-Hospital Cardiac Arrest randomized clinical trial comparing routine administration of sodium bicarbonate with placebo during attempted resuscitation of 779 patients with in-hospital cardiac arrest. The physiological rationale for administering sodium bicarbonate is to temporarily reduce the profound metabolic acidosis that develops during cardiac arrest to reverse myocardial depression and improve catecholami...