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August 9, 1976

Sodium Bicarbonate Administration During Cardiac Arrest-Reply

Author Affiliations

Johns Hopkins Medical Institutions Baltimore

JAMA. 1976;236(6):563. doi:10.1001/jama.1976.03270060016015

In Reply.—  We appreciate the comments of Harrison et al with regard to the use of sodium bicarbonate during cardiac resuscitation. The results of these investigators with resuscitation of patients by trained health personnel are enviable. These results clearly demonstrate that one can achieve effective resuscitation despite the administration of large amounts of sodium bicarbonate. I would encourage these investigators to undertake a controlled trial of high-dose sodium bicarbonate during cardiac resuscitation.We do not have survival data on our animal preparations since these were short-term experiments. As pointed out in our article, other investigators1,2 found little beneficial effect of sodium bicarbonate in animal survival. Relatively small amounts of sodium bicarbonate may in fact be beneficial, not so much by virtue of the effect on pH and Pco2 but rather by virtue of the effects on osmolality.3 The studies of Fillmore and associates4 point to the