Nab8.0

Sodium Bicarbonate Research

40 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.

Meta-Analysisn=1,644

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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.

Systematic Reviewn=1,043

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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).

Meta-Analysisn=2,037

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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

Meta-Analysisn=2,110

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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.

Meta-Analysisn=21,402

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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.

Systematic Reviewn=701

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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.

Meta-Analysisn=4,877

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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-Analysisn=1,461

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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.
Further research warranted to confirm findings

Meta-Analysisn=1,092

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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).

Meta-Analysisn=23

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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.

Meta-Analysisn=149

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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

Meta-Analysisn=600

DOI

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.

Meta-Analysis

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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.

Meta-Analysisn=341

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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.

Meta-Analysis

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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.

Meta-Analysis

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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.

Systematic Review

DOI

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.

Meta-Analysisn=19

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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
Further research warranted to confirm findings

Meta-Analysis

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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.
Further research warranted to confirm findings

Meta-Analysis

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