Effectiveness of Sodium Bicarbonate Administration in Out-of-Hospital Cardiac Arrests: An Updated Systematic Review and Meta-Analysis

Administration of sodium bicarbonate in patients with OHCA was not associated with improved ROSC or survival to discharge. Therefore, its routine use cannot be recommended. However, our review does not exclude the possibility of benefit in selected, guideline-specified contexts such as hyperkalemia or tricyclic antidepressant overdose, or when administered early during resuscitation. Further high-quality studies with standardized reporting of etiology, timing, dose, and airway management are needed to clarify these potential indications.