The debate over the administration of sodium bicarbonate in cardiac arrest has been going on for several decades, swinging like a pendulum from "first-line drug" to "not indicated" to the recent guidelines advocating "a small bolus under special conditions (metabolic acidosis, intoxication, long-term resuscitation)". A targeted, blood-gas controlled application under optimised ventilation conditions has not yet been evaluated prehospitally. Our preliminary studies have shown that an arterial puncture/line as well as measurement of blood gases is feasible in preclinical conditions. This multicentre trial including 5 centres and 10 physician-staffed emergency systems is designed to compare, in a prospective randomised controlled study, the effect of a calculated dosage of sodium bicarbonate based on the patient´s base deficit and weight, on ROSC (= return of spontaneous circulation) and on the secondary survival of cardiac arrest patients. The null hypothesis is that there is no or negative impact on survival.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
700
Administration of a calculated amount of sodium bicarbonate 8% \[SB\] after arterial blood gas measurement according to Base Excess \[BE\] and Body weight \[kg\]. Formula: SB \[ml\] = -BE \* kg \* 0.1
Administration of a calculated amount of sodium chloride 0.9% \[SC\] after arterial blood gas measurement according to Base Excess \[BE\] and Body weight \[kg\]. Formula: SC \[ml\] = -BE \* kg \* 0.1
Landeskrankenhaus Klagenfurt
Klagenfurt, Carinthia, Austria
Landesklinikum Wiener Neustadt
Wiener Neustadt, Lower Austria, Austria
Landeskrankenhaus Bruck / Mur
Bruck / Mur, Styria, Austria
LKH Graz West
Graz, Styria, Austria
Medical University Graz
Graz, Styria, Austria
AKH Linz
Linz, Upper Austria, Austria
Rate of return of spontaneous circulation (ROSC)
Time frame: Within five hours from start of resuscitation.
Survival to discharge after cardiac arrest
Discharge from hospital
Time frame: participants will be followed for the duration of hospital stay, an expected average of 5 weeks
Survival after one year of hospital discharge
Time frame: One year after event
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