Evaluating the Clinical Effectiveness of Sodium Bicarbonate for Critically Ill Patients With Metabolic Acidosis and Acute Kidney Injury (ESCALATE)
The study investigates whether sodium bicarbonate is able to reduce the occurrence of major adverse kidney events on day 90 (MAKE90) in critically ill patients with metabolic acidosis and acute kidney injury (AKI). While its efficacy in this context has been suggested in a subgroup analysis of the BICAR-ICU trial it has not been confirmed in a double-blinded randomized controlled trial to date.
• Adult ≥ 18 years
• Critically ill patients (requiring treatment on an ICU or IMC)
• Metabolic acidosis, defined as all of the following:
‣ Arterial pH ≤7.25
⁃ PaCO2 \< 6.5kPa (\<49 mmHg)
⁃ Standard bicarbonate ≤20 mmol/L
⁃ Standard Base Excess \<-2
• AKI stage 2 or 3 of the KDIGO classification
• Written informed consent of the patient or legal representative or authorized representative or emergency inclusion (according to Article 35 EU-Regulation 536/2014)