[Out-of-hospital buffer therapy in heart arrest]

Abstract

The effects of infusing a buffer solution on resuscitability and outcome were tested in patients during out-of-hospital cardiac arrest. 502 adults with ventricular fibrillation or asystole with failure of first attempt at defibrillation were entered into a prospective, randomized, double-blind, controlled trial where one group received buffer and the other group placebo (saline). 87 of 245 (36%) patients who received a buffer were admitted to hospital and 24 (10%) were discharged alive, as against 92 of 257 (36%) admitted to hospital and 35 (14%) discharged alive for those who received placebo. Only 16 of the 502 patients had arterial alkalosis on arrival at hospital and no patient had a positive base excess. Patients resuscitated after out-of-hospital cardiac arrest had metabolic acidosis but buffer therapy did not improve outcome.