Background & Objective: Sepsis is one of the the main global causes of morbidity and mortality. Acute acidemia is often observed during critical illness, which reduces the effectiveness of catecholamines. Sodium bicarbonate injection is a management choice for severe metabolic acidemia. Determining the probability of hemodynamic stability by restoring intravascular volumes along with the administration of sodium bicarbonate within the first three hours in severe sepsis and septic shock management.
 Materials & Methods: 72 patients with severe sepsis or septic shock were randomly allocated into two groups. In the control group, initial targeted treatment with 30 cc/kg of isotonic crystalloid serum was done in the first 3 hours. In the intervention group, sodium bicarbonate was added to the serum volume, similar to the control group, in the amount equal to half of the calculated deficiency. All orders, such as obtaining blood samples for necessary data and monitoring at the beginning and end of the intervention, were the same for both groups.
Results:  There was no meaningful difference among groups in demographic information, hemodynamic variables and arterial blood gas analysis variables before treatment, duration of hospitalization, and patient mortality; The recorded data of average arterial pressure, systolic and diastolic blood pressure, central venous pressure, PH, HCO3, BE and Lactate at the end of the treatment recorded, a significant difference was observed in the two groups.
Conclusion:  Adding SB to Early Goal-Directed Therapy may offer clinical and hemodynamic benefits, the limited sample size reduces generalizability. Further large-scale studies are required to confirm the safety and efficacy.