Jamme M, et al. - Researchers examined all consecutive out-of-hospital cardiac arrest (OHCA) patients admitted between 2007 and 2012, to determine risk factors and evaluate the effect of metabolic acidosis on outcome after OHCA. Metabolic acidosis was defined by a positive base deficit and was categorized by quartiles. Linear and logistic regressions were used. The factors that showed an association with an increased level of acidosis included male gender, resuscitation duration, initial shockable rhythm and post-resuscitation shock. In OHCA patients, severe metabolic acidosis was frequently detected and was found to be related to poorer outcome, in particular, due to refractory shock. However, survival to intensive care unit discharge with complete neurological recovery was reported in about 7% of patients with a very severe metabolic acidosis.