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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Metabolic acidosis (MA) is a frequent complication among critically ill patients and is associated with increased mortality and organ dysfunction. However, the efficacy of sodium bicarbonate (SB) therapy for MA in this population remains uncertain, with conflicting results across randomized and observational studies. This systematic review and meta-analysis aims to evaluate the impact of SB administration on mortality and kidney outcomes among critically ill adults with MA.
A comprehensive literature search was performed through October 5, 2025, using PubMed, Scopus, Web of Science, and Google Scholar. Eligible studies included randomized or observational studies comparing SB therapy versus no SB in critically ill adults with MA. Random-effects models were applied when heterogeneity was substantial (I² > 50%), and fixed-effect models otherwise. We used RevMan 5.4 software for the statistical analysis.
Eighteen studies met our inclusion criteria; 14 were included in the quantitative synthesis with 29314 patients. SB therapy did not significantly affect 28–30-day mortality (RR = 1.15; 95% CI 0.85–1.56; P = 0.36) but was associated with higher ICU mortality (RR = 1.54; 95% CI 1.15–2.05; P = 0.004) and in-hospital mortality (RR = 1.61; 95% CI 1.06–2.43; P = 0.02). SB did not significantly alter renal replacement therapy requirement (RR = 1.17; 95% CI 0.74–1.83; P = 0.51), major adverse kidney events (RR = 0.93; 95% CI 0.83–1.03; P = 0.17), cumulative fluid intake (MD = −2.16 mL; 95% CI −59.51 to 55.20; P = 0.94), or ICU/hospital stay. However, SB use was associated with shorter mechanical ventilation duration (MD = −0.26 days; 95% CI −0.48 to −0.04; P = 0.02).
Sodium bicarbonate therapy was associated with increased ICU and in-hospital mortality in critically ill adults with metabolic acidosis, without improving short-term survival or renal outcomes. Although it slightly reduced mechanical ventilation duration, the overall findings raise concerns regarding its safety in unselected populations. Further randomized trials are needed to validate our results and identify patient subgroups that may benefit from SB therapy.
