Interventions
Sodium Bicarbonate
The trial drug will consist of 50 ml of 1 mmol/ml sodium bicarbonate given as soon as possible after the first dose of adrenaline.
If the patient remains in cardiac arrest, one additional dose of sodium bicarbonate will be administered after the second dose of adrenaline for a maximum of two doses.
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Although the different mechanisms are debated, we postulate that during cardiac arrest with severe acidosis, the administration of bicarbonate will increase pH and counteract the negative consequences of acidosis, improve the chance of return of spontaneous circulation, and ultimately improve more long-term outcomes.
Intervention
Saline
The placebo will consist of 50 mL of 9 mg/mL NaCl (“normal saline”) from containers identical to the sodium bicarbonate containers.
Normal saline is often administered to critically ill patients and have no known effects or side-effects with these small volumes.
Placebo
Medication box
The trial drugs will be placed in a blinded trial kit (a small box) containing two glass vials each with 50 ml of sodium bicarbonate (1 mmol/ml) or corresponding placebo (0.9% NaCl) ensuring allocation concealment.
The trial kits will be prepared at the Capital Region Pharmacy, a company that specializes in the production of medicine and is approved by the Danish Health authorities, and shipped to the participating sites regularly.
The drugs will be administered according to a medication guide (Danish).
Trial procedures and REDCap registration videos (Danish)
Trial procedures:
Registration in REDCap (Part 1):
REDCap-registrering af hjertestoppatient, som er blevet inkluderet i BIHCA forsøget
Registration in REDCap (Part 2)
REDCap-registrering af hjertestoppatient, som ikke er blevet inkluderet i BIHCA forsøget