Volume 17 Supplement 2

33rd International Symposium on Intensive Care and Emergency Medicine

Open Access

Perioperative sodium bicarbonate to prevent acute kidney injury after cardiac surgery: a multicenter double-blind randomized controlled trial

  • A Haase-Fielitz1,
  • M Haase1,
  • M Plass2,
  • P Murray3,
  • M Bailey4,
  • R Bellomo5 and
  • S Bagshaw6
Critical Care201317(Suppl 2):P413


Published: 19 March 2013


Evidence suggests a nephroprotective effect of urinary alkalinization in patients at risk of acute kidney injury (AKI).


In a multicenter, double-blind, RCT we enrolled 350 adult cardiac surgery patients. At induction of anesthesia, patients received either 24 hours of intravenous infusion of sodium bicarbonate (5.1 mmol/kg) or sodium chloride (5.1 mmol/kg). The primary endpoint was the proportion of patients developing AKI.


Sodium bicarbonate increased urinary pH (from 6.0 to 7.5, P 0.001). More patients in the bicarbonate group (83/174 (47.7%)) developed AKI compared with control (64/176 (36.4%), OR = 1.60 (95% CI, 1.04 to 2.45); unadjusted P = 0.032). A greater postoperative increase in urinary NGAL in patients receiving bicarbonate infusion was observed compared with control (P = 0.011). The incidence of postoperative RRT was similar but hospital mortality was increased in patients treated with bicarbonate compared with chloride (11/174 (6.3%) vs. 3/176 (1.7%), OR 3.89 (1.07 to 14.2), P = 0.031). See Figure 1.
Figure 1

(abstract P413)


On this basis of our findings we do not recommend the use of perioperative infusions of sodium bicarbonate to reduce the incidence or severity of AKI in this patient group.

Authors’ Affiliations

Otto von-Guericke University
German Heart Center
University College
Austin Hospital
University of Alberta


© Haase-Fielitz et al.; licensee BioMed Central Ltd. 2013

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.