Zhang Z, et al. - Researchers used a marginal structural Cox model as well as data from Beth Israel Deaconess Medical Center in order to examine the links between the use of IV sodium bicarbonate and death in patients with acute kidney injury and metabolic acidosis in this extensive US-based critical care database named Medical Information Mart for Intensive Care. A higher Sequential Organ Failure Assessment, lower pH, and bicarbonate concentration were seen in patients who received sodium bicarbonate treatment vs those who did not. No evidence demonstrating the benefit of IV sodium bicarbonate in patients with acute kidney injury and acidosis was generated in the analysis by adjusting for potential confounders. In some highly selected subgroups, including in subgroups of pancreatitis and severe acidosis, and in patients with severe bicarbonate deficit, the potential beneficial effects of sodium bicarbonate were suggested, yet the findings require to be confirmed in experimental trials.