The following is a summary of “Sodium bicarbonate Ringer’s solution for hemorrhagic shock: A meta-analysis comparing crystalloid solutions,” published in the February 2024 issue of Emergency Medicine by Shafique, et al.

Fluid resuscitation is a critical aspect of managing Traumatic Hemorrhagic Shock (THS). Bicarbonated Ringer’s solution (BRS) has garnered interest due to its resemblance to human extracellular fluid and potential hemodynamic benefits. For a study, researchers sought to assess the efficacy, mortality rates, hemodynamic effects, and adverse outcomes of Sodium Bicarbonate Ringer’s Solution in treating hemorrhagic shock compared to other interventions.

A systematic review of literature was conducted by searching databases including Cochrane, EMBASE, MEDLINE, and PubMed. Predefined criteria were used to extract relevant data and evaluate study quality. Outcome measures included survival rates, mortality, mean arterial pressure (MAP), heart rate (HR), and adverse events.

A meta-analysis of three studies revealed that compared to other crystalloids, BRS had an odds ratio for survival of 1.86 (95% CI: 0.94, 3.71; P = 0.08; I2 = 0%), an odds ratio for total adverse events of 0.14 (95% CI: 0.06, 0.35; P < 0.0001; I2 = 22%), a mean difference in heart rate of -4.49 (95% CI: -7.55, -1.44; P = 0.004; I2 = 13%), and a mean difference in mean arterial pressure of 2.31 (95% CI: -0.85, 5.47; P = 0.15; I2 = 66%).

BRS exhibited a significant reduction in complications such as adult respiratory distress syndrome (ARDS), Multiple Organ Dysfunction (MODS), and total adverse effects compared to other solutions in treating THS. Additionally, THS patients resuscitated with BRS experienced a notable decrease in heart rate. The findings suggested that BRS may contribute to organ stability and potentially improve survival due to its similarity to human extracellular fluid and its minimal impact on the liver.

Reference: sciencedirect.com/science/article/abs/pii/S0735675723006071