Randomized trial demonstrates lower bicarbonate levels in patients with continuous veno-venous hemofiltration, suggesting improved dosage management.
This study aimed to explore the effectiveness of sodium bicarbonate prereduction during continuous veno-venous hemofiltration (CVVH) with regional citrate anticoagulation (RCA). Patients undergoing CVVH with RCA were randomly divided into a control group and a prereduction group, with the latter receiving reduced sodium bicarbonate concentration levels to achieve the desired level after three hours of treatment. The investigation focused on variations in pH, bicarbonate ion levels and the frequency of sodium bicarbonate dosage adjustments at different intervals during CVVH. The 41 participants (20 in the control group, 21 in the prereduction group) treated from July 2023 to February 2024, had no statistically significant differences in demographic or clinical characteristics. The prereduction group demonstrated significantly lower bicarbonate ion levels in the 4th hour (23.62 ± 2.66 mmol/L) compared with the control group (26.57 ± 2.17 mmol/L, P < 0.05) and required fewer bicarbonate adjustments (0 [0,1] times vs. 2 [1,3] times in the control group, P < 0.05). Sodium bicarbonate prereduction during CVVH using RCA minimises bicarbonate ion fluctuations and reduces the need for dosage adjustments.
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Wu et al. (2025) studied this question.
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