A new study suggests that the risk of acute kidney injury (AKI) in patients who undergo open heart surgery is not reduced by the administration of sodium bicarbonate-based infusion to induce urinary alkalinization during and after surgery even though a previous study did find some benefit.
These are the conclusions of a study by Anja Haase-Fielitz of the Otto-von-Guericke-University in Magdeburg, Germany, Rinaldo Bellomo of the Austin Hospital in Melbourne, Australia, and colleagues, published in this week's PLOS Medicine, that suggest an infusion of sodium bicarbonate during open heart surgery is not a useful treatment for preventing AKI following open heart surgery.
The authors conducted a multicenter, double-blinded, randomized controlled in 350 adult patients undergoing open heart surgery with the use of cardiopulmonary bypass. Patients received either 24 hours of intravenous infusion of sodium bicarbonate or sodium chloride (saline control) at the beginning of surgery.
The authors say: "Urinary alkalinization using sodium bicarbonate infusion was not found to reduce the incidence of acute kidney injury or attenuate tubular damage following open heart surgery; however, it was associated with a possible increase in mortality." They add: "On this basis of our findings we do not recommend the prophylactic use of perioperative infusions of sodium bicarbonate to reduce the incidence or severity of acute kidney injury in this patient group."