Journal of Advances in Medical and Biomedical Research

en Investigating the Effect of Additional Sodium Bicarbonate Solution on Hemodynamic Management in the First Three Hours in Patients with Severe Sepsis and Septic Shock Clinical Medicine Clinical Medicine کارآزمایی بالینی Clinical Trials 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. EGDT, Sepsis, Shock, Sodium Bicarbonate 1 7 http://journal.zums.ac.ir/browse.php?a_code=A-10-7176-1&slc_lang=en&sid=1 Arash Peivandi Yazdi peivandiA@mums.ac.ir 5200319475328460088256 5200319475328460088256 No Department of Anesthesiology and Critical Care, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Ehsan Noori ehsan_n78@yahoo.com 5200319475328460088257 5200319475328460088257 No Department of Anesthesiology and Critical Care, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Leila Mashhadi mashhadil@mums.ac.ir 5200319475328460088258 5200319475328460088258 Yes Department of Anesthesiology and Critical Care, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Saeed Akhlaghi akhlaghiS@mums.ac.ir 5200319475328460088259 5200319475328460088259 No Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran Andia Peivandi Yazdi mailto:andiapeivandi@gmail.com 5200319475328460088260 0009-0004-9828-0713 No Dentistry Student, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran