Sodium Bicarbonate Research
39 peer-reviewed studies · Evidence score: 8/10
Effect of different mouthwashes on ventilator-related outcomes and mortality in intensive care unit patients: A network meta-analysis
He Q et al. • Australian critical care : official journal of the Confederation of Australian Critical Care Nurses (2025)
Antimicrobial mouthwashes, especially chlorhexidine, pose potential risks in ICU patients; oxidising solutions demonstrate relative safety.
- Oxidising agents showed a trend towards reducing the incidence of VAP compared to the control group (risk ratio: 0.24, 95% confidence interval: 0.05-1.10).
- Administration of saline was associated with a notable reduction in ICU mortality (risk ratio: 0.18, 95% confidence interval: 0.04-0.88) versus no mouthwash.
- Antimicrobial mouthwashes, especially chlorhexidine, pose potential risks in ICU patients; oxidising solutions demonstrate relative safety.
Effects of dietary supplements on athletic performance in elite soccer players: a systematic review
Abreu R et al. • Journal of the International Society of Sports Nutrition (2023)
Still, more well-designed research with elite soccer players is needed to improve support and advice regarding the use of dietary supplements for athletic performance enhancement.
- Nitrate-rich beetroot concentrate can attenuate performance decrease in the days following matches.
- Further investigation with sodium bicarbonate alone is necessary, as supplementation protocols with elite players included other substances.
- Finally, the available data does not support yohimbine supplementation or the use of Resurgex Plus® to improve athletic performance in elite soccer players.
Sodium Bicarbonate Treatment and Clinical Outcomes in Chronic Kidney Disease with Metabolic Acidosis: A Meta-Analysis
Yang TY et al. • Clinical journal of the American Society of Nephrology : CJASN (2024)
In patients with CKD and MA, sodium bicarbonate supplementation may provide potential benefits in preventing the deterioration of kidney function and increasing muscle mass.
- Fourteen RCTs comprising 2037 patients demonstrated that sodium bicarbonate supplementation significantly improved eGFR (standardized mean difference [SMD], 0.33; 95% confidence interval [CI], 0.03 to 0.63; P = 0.03).
- The group receiving sodium bicarbonate had a lower hospitalization rate (odds ratio, 0.37; 95% CI, 0.25 to 0.55; P < 0.001).
- Higher mid-arm muscle circumference was observed with sodium bicarbonate treatment compared with those without (SMD, 0.23; 95% CI, 0.08 to 0.38; P = 0.003, I2<0.001).
Effect of Sodium Bicarbonate on Systolic Blood Pressure in CKD: A Systematic Review and Meta-Analysis
Beynon-Cobb B et al. • Clinical journal of the American Society of Nephrology : CJASN (2023)
Our results suggest, with moderate certainty, that sodium bicarbonate supplementation does not adversely affect systolic BP in CKD or negatively influence antihypertensive medication requirements.
- Similarly, there was no significant increase in the use of antihypertensive medication or diuretics in individuals taking sodium bicarbonate, whereas there was a greater decrease in antihypertensive medication use in individuals taking sodium bicarbonate compared with controls.
- Our results suggest, with moderate certainty, that sodium bicarbonate supplementation does not adversely affect systolic BP in CKD or negatively influence antihypertensive medication requirements.
- Further research warranted to confirm findings
The effect of sodium bicarbonate on OHCA patients: A systematic review and meta-analysis of RCT and propensity score studies
Xu T et al. • The American journal of emergency medicine (2023)
In patients with OHCA, sodium bicarbonate administration was associated neither with short-term survival rate nor with long-term survival rate, it may even worsen the long-term survival.
- The primary outcome of this meta-analysis showed that short-term survival rate between the two groups was no difference (OR = 1.04; 95% CI, 0.98 to 1.12; P = 0.21; χ2 = 6.68; I2 = 25%).
- Secondary outcome demonstrated that long -term survival rate between the two groups was no difference (OR = 0.82; 95% CI, 0.50 to 1.34; P = 0.43; χ2 = 14.96; I2 = 80%).
- In patients with OHCA, sodium bicarbonate administration was associated neither with short-term survival rate nor with long-term survival rate, it may even worsen the long-term survival.
Nutritional Ergogenic Aids in Cycling: A Systematic Review
Valiño-Marques A et al. • Nutrients (2024)
However, no statistically significant effects were identified for the remaining supplements, whether administered individually or in combination.
- However, no statistically significant effects were identified for the remaining supplements, whether administered individually or in combination.
- Thirty-six articles involving 701 participants were included in this review, examining supplementation with caffeine (n = 5), creatine (n = 2), sodium bicarbonate (n = 6), beta-alanine (n = 3), and nitrates (n = 8).
- Additionally, supplemental combinations of caffeine and creatine (n = 3), caffeine and sodium bicarbonate (n = 3), caffeine and nitrates (n = 1), creatine and sodium bicarbonate (n = 1), and sodium bicarbonate and beta-alanine (n = 4) were analyzed.
Sodium bicarbonate administration during in-hospital pediatric cardiac arrest: A systematic review and meta-analysis
Chang CY et al. • Resuscitation (2021)
This meta-analysis of non-randomized studies supported current PLS guideline that routine administration of SB is not recommended in pediatric cardiac arrest except in special resuscitation situations.
- Meta-analysis showed that SB administration during pediatric cardiac resuscitation was associated with a significantly decreased rate of survival to hospital discharge (odds ratio [OR], 0.40; 95% confidence interval [CI], 0.25-0.63, p value = 0.0003).
- The subgroup analysis showed a significantly decreased rate of survival to hospital discharge in both the "before 2010" subgroup (OR 0.47; 95% CI 0.30-0.73; p value = 0.006) and the "after 2010" subgroup (OR 0.46; 95% CI 0.25-0.87; p value = 0.02).
- This meta-analysis of non-randomized studies supported current PLS guideline that routine administration of SB is not recommended in pediatric cardiac arrest except in special resuscitation situations.
β-alanine supplementation to improve exercise capacity and performance: a systematic review and meta-analysis
Saunders B et al. • British journal of sports medicine (2017)
β-alanine had a significant overall effect while subgroup analyses revealed a number of modifying factors.
- A significant overall effect size of 0.18 (95% CI 0.08 to 0.28) was shown.
- Meta-regression demonstrated that exercise duration significantly (p=0.004) moderated effect sizes.
- Subgroup analyses also identified the type of exercise as a significant (p=0.013) moderator of effect sizes within an exercise time frame of 0.5-10 min with greater effect sizes for exercise capacity (0.4998 (95% CI 0.246 to 0.753)) versus performance (0.1078 (95% CI -0.201 to 0.416)).
Meta-Analysis of Sodium Bicarbonate Therapy for Prevention of Cardiac Surgery-Associated Acute Kidney Injury
Kim JH et al. • Journal of cardiothoracic and vascular anesthesia (2015)
Perioperative administration of sodium bicarbonate did not reduce the rate of CSA-AKI in randomized controlled trials.
- Perioperative administration of sodium bicarbonate did not reduce the rate of CSA-AKI in randomized controlled trials.
- Published in Journal of cardiothoracic and vascular anesthesia (2015)
- Further research warranted to confirm findings
Sport supplementation in competitive swimmers: a systematic review with meta-analysis
Domínguez R et al. • Journal of the International Society of Sports Nutrition (2025)
Creatine supplementation demonstrated ergogenic benefits for competitive swimmers, although the evidence supporting the use of this supplement is still limited.
- This revision included 23 studies, 16 of them (69.6%) qualified as excellent and 7 (30.4%) as good at the methodological level based on the punctuation in the PEDro scale.
- The systematic review included 422 swimmers (61.8% male, 38.2% female), with distances assessed ranging from 50 m to 800 m, including studies employing interval procedures.
- Creatine showed a significant effect (ES = -0.46; 95% CIs = -0.75 to -0.17, p = 0.002; I2 = 11%) on swimming performance, while the rest of the analyzed supplements did not show significant effects (all p > 0.05).
Sodium bicarbonate supplementation and the female athlete: A brief commentary with small scale systematic review and meta-analysis
Saunders B et al. • European journal of sport science (2022)
This meta-analysis examined the effects of Sodium Bicarbonate.
- Results indicated a pooled blood bicarbonate increase of 7.4 [95%CrI: 4.2-10.4 mmol·L-1] following supplementation and a pooled standardised exercise effect size of 0.37 [95%CrI: -0.06-0.92].
- The SB literature is skewed, with only 20% (30 studies) of studies employing female participants, of which only 11 studies (7.4%) provided group analyses exclusively in women.
- A total of 149 SB articles were identified, 11 of which contained individual group data for women.
Sodium bicarbonate for high-intensity exercise: Meta-analysis
Carr AJ et al. • European Journal of Sport Science (2011)
Sodium bicarbonate improved performance by 1.7% in high-intensity events.
- 1.7% performance improvement
- Most effective for 1-7 min efforts
- Consistent ergogenic effect
Effects of sodium bicarbonate on 200 m time trial performance and physiological responses in swimmers: a systematic review and meta-analysis of randomized controlled trials
Huang D et al. • Research in sports medicine (Print) (2025)
These findings suggest NaHCO₃ enhances certain physiological responses but does not improve 200 m performance, though data limitations require cautious interpretation.
- Results showed significant increases in blood bicarbonate (SMD = 1.09, 95% CI = 0.38 to 1.79, P<0.01), blood lactate (SMD = 0.76, 95% CI = 0.24 to 1.29, P<0.01) and blood pH (SMD = 1.02, 95% CI = 0.33 to 1.71, P<0.01), but no effect on 200 m time (SMD = 0.26, 95% CI -0.58 to 1.10).
- A comprehensive search across five databases identified eligible randomized controlled trials comparing NaHCO₃ with placebo.
- Outcomes were 200 m time, blood bicarbonate, blood lactate, and blood pH.
Impact of sodium bicarbonate therapy on hemodynamic parameters in infants: a meta-analysis
Loomba RS et al. • The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians (2022)
Sodium bicarbonate has a statistically significant but not clinically significant impact on partial pressure of carbon dioxide and base deficit 60 min after sodium bicarbonate administration in critically ill infants.
- Base deficit significantly improved with a decrease of 2.80 (p = .001) and the partial pressure of carbon dioxide significantly decreased by a mean of -1.65 mmHg (p = .010).
- Sodium bicarbonate has a statistically significant but not clinically significant impact on partial pressure of carbon dioxide and base deficit 60 min after sodium bicarbonate administration in critically ill infants.
- There is no difference noted in pH, partial pressure of oxygen, or saturation by pulse oximetry.
Effects of Different Dietary Supplements on Swimming Performance: A Systematic Review and Network Meta-Analysis
Huang D et al. • Nutrients (2024)
Dietary supplements might provide benefits for improving swimming performance.
- L-arginine (Arg) demonstrated superior performance to the placebo (SMD = -1.66, 95% CI [-2.92, -0.44]), emerging as the most effective intervention for reducing 100 swimming time (SUCRA = 89.5%).
- Beta-alanine (BA) was the best intervention for improving blood lactate (SUCRA = 80%).
- Creatine combined with sodium bicarbonate (Creatine_NaHCO3) significantly increased blood pH compared to the placebo (SMD = 3.79, 95% CI [1.85, 5.80]), with a SUCRA score of 99.9%, suggesting it is the most effective intervention for this parameter.
Nutritional Ergogenic Aids in Combat Sports: A Systematic Review and Meta-Analysis
Vicente-Salar N et al. • Nutrients (2022)
Caffeine is the only NEA that has shown strong evidence for performance enhancement in combat sports.
- In this regard, abilities including the number of attacks, reaction time, handgrip strength, power and TTE, among others, were improved.
- Buffering supplements such as sodium bicarbonate, sodium citrate and beta-alanine may have a promising role in high and intermittent exertion during combat, but more studies are needed in grappling combat sports to confirm their efficacy during sustained isometric exertion.
- Other NEAs, including creatine, beetroot juice or glycerol, need further investigation to strengthen the evidence for performance enhancement in combat sports.
Effects of sodium bicarbonate supplementation on exercise performance: an umbrella review
Grgic J et al. • Journal of the International Society of Sports Nutrition (2021)
Based on meta-analyses of moderate to high quality, it can be concluded that sodium bicarbonate supplementation acutely enhances peak anaerobic power, anaerobic capacity, performance in endurance events lasting ∼45 s to 8 min, muscle endurance, 2000-m rowing performance, and high-intensity intermittent running.
- The ergogenic effects ranged from trivial (pooled effect size: 0.09) to large (pooled effect size: 1.26).
- For example, sodium bicarbonate produced similar effects on performance in endurance events lasting ∼45 s to 8 min, muscle endurance tests, and Yo-Yo test (pooled effect size range: 0.36 to 0.40).
- More research is needed among women to improve the generalizability of findings.
Alkalinization Using Sodium Bicarbonate for COVID-19 Treatment: A Systematic Review and Meta-Analysis
Shafiee A et al. • Journal of evidence-based integrative medicine (2024)
With low certainty of evidence, alkalinization (by sodium bicarbonate) can be an efficient and safe adjuvant treatment for COVID-19 patients.
- The results of our meta-analysis showed a significant reduction in mortality rate in the alkalinization group compared to controls (RR 0.73, 95% CI: 0.56-0.95; I2 = 0%).
- The results of our meta-analysis showed a significant reduction in the duration of hospitalization in the alkalinization group compared to controls with very low certainty of evidence (SMD -0.66, 95% CI: -0.97 to -0.35; I2 = 36%).
- With low certainty of evidence, alkalinization (by sodium bicarbonate) can be an efficient and safe adjuvant treatment for COVID-19 patients.
Can Sodium Bicarbonate Supplementation Improve Combat Sports Performance? A Systematic Review and Meta-analysis
Miranda WAS et al. • Current nutrition reports (2022)
New experimental studies need to be published that assess the effect of acute and chronic NaHCO3 supplementation in specific combat sports tests and in women.
- Meta-analysis examining Sodium Bicarbonate efficacy
- Published in Current nutrition reports (2022)
- Further research warranted to confirm findings
EFFICACY OF 67% SODIUM BICARBONATE TOOTHPASTE FOR PLAQUE AND GINGIVITIS CONTROL: A SYSTEMATIC REVIEW AND META-ANALYSIS
Taschieri S et al. • The journal of evidence-based dental practice (2022)
The clinical use of 67% sodium bicarbonate toothpaste can improve periodontal health in patients with gingivitis.
- Significant improvement of gingival index, bleeding index, and plaque index was observed in patients using 67% sodium bicarbonate toothpaste as compared with control subjects.
- Published in The journal of evidence-based dental practice (2022)
- Further research warranted to confirm findings