Sodium Bicarbonate Implications During Coronary Artery Bypass Grafting

Abstract

Acidemia is common in cardiac patients undergoing coronary artery bypass graft (CABG) surgery. Acute metabolic acidosis (MA) during CABG surgery is typically an indication of tissue hypoperfusion.1,2,3,4 This pH imbalance is thought to contribute to cardiac instability, reduced responsiveness to vasopressors, and increased mortality.1,2,5 As a result, anesthesia providers commonly administer sodium bicarbonate (SB) in efforts to correct the pH imbalance and restore cardiac function.1 Despite its prevalence, little evidence supports treating hypoperfusion-related MA with SB. This leads to the question, in patients undergoing CABG who develop MA intraoperatively, does correcting the pH with SB reduce postoperative mortality