EMCrit 428 - A Few Things
🔹 ARISE Fluids: Does the 30 mL/kg sepsis mandate finally crumble?
🔹 BIHCA & SODABIC
🔹 Traumatic Tamponade: Can a 12Fr catheter prevent a thoracotomy in austere settings?
🔹 DKA Guidelines: Why the ADA has it completely backward when it comes to the anion gap.
emcrit.org/428

On the third day of Christmas, my true love gave to me… 🎶

📊 Three key outcomes
🫀 Two boluses of bicarb
⚡ And ROSC in the BIHCA cardiac arrest trial 🎄

#CCR26
criticalcarereviews.com/meetings/ccr26

#CCR26 Ary Serpa Neto provides the editorial for the BIHCA trial. He reiterates the absence of evidence of bicarb and that we all use it (!)

What should clinicians do tomorrow? Dr Serpa Neto: avoid routine use, but role as a rescue therapy / specific conditions not tested

🌟 Bicarbonate in In-Hospital Cardiac Arrest: Time to Reconsider the Evidence?
📅 18 Sept | ⏰ 16:00–17:00
Discover the #BIHCA trial results, expert perspectives. Join the conversation at #RESUS26.
🔗 Programme: 🔗 bit.ly/3TmiyyV
📝 Register: www.erc.edu/events/congr...
#EduSky #CPR #savelives #ResusSky

#CCR26 BIHCA trial, RESULTS!

88% patients had non-shockable initial rhythm. 8 mins to trial drug!! 70% patients received 2 drug doses.

PRIMARY O: Bicarb 39% vs. placebo 37%; RR 1.05 [0.88, 1.24]; p = 0.62

2° O: No statistical difference in survival (30/90d).

Results in @jama.com

Routine sodium bicarbonate has largely disappeared from modern ALS algorithms, but it continues to be used in many cardiac arrests. We review the BIHCA trial and discuss what it means for emergency physicians and prehospital clinicians.

#CCR26 BIHCA outline:
P: Adults with in-hospital cardiac arrest who had received ≥1 dose adrenaline
I: 50mmol IV NaHCO3-
C: Placebo
1° O: Sustained ROSC (defined as 20 mins without support)
Sample size: n=778
Analysis: Modified ITT

Thoughts on design? Predictions?

#CCR26 BIHCA trial up next - sodium bicarbonate for in-hospital cardiac arrest, presented by Asger Granfeldt and Lars Wiuff Andersen.

The triallists open by comparing in-hospital with out-of-hospital cardiac arrest

Tune-in live at criticalcarereviews.com

➡️ Does bicarbonate improve outcomes in in-hospital cardiac arrest?

➡️ Or could correcting acidosis during CPR be ineffective—or even harmful?

➡️ Join us in June to hear the BIHCA trial results

Register now: criticalcarereviews.com/meetings/ccr...

eu queria muito ter um amigo bihca pra cantar comigo 😭🥺

Sodium bicarbonate pushes for cardiac arrest: good faith or bad care? • BIHCA trial rules out a miracle cure, but there's more to consider

youtube.com/shorts/3hnTk...