Bicarb for AKI + acidosis prevents dialysis needs in the ICU (BICARICU-2 trial)

High-concentration NaHCO3 seemed to help in underpowered trial

Critically ill patients with acute kidney injury commonly become severely acidemic, which (at pH ≤ 7.1-7.2) is associated with impaired cardiac contractility, reduced effectiveness of vasopressors, and increased risk for cardiac arrhythmias.

But is the acidemia or the underlying illness (e.g., sepsis with lactic acidosis) causing these physiologic deran…