Evidence supporting the use of: Bicarbonate (unspecified)
For the health condition: Poisoning (general)

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Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Bicarbonate (typically in the form of sodium bicarbonate) is scientifically validated for use in certain types of poisoning, particularly those involving toxins that cause metabolic acidosis or cardiotoxicity. The most well-established use is in the management of tricyclic antidepressant (TCA) overdose, where sodium bicarbonate is administered to counteract cardiac toxicity by alkalinizing the serum and increasing serum sodium concentration. This can reduce the binding of TCAs to sodium channels in cardiac tissue, thus mitigating arrhythmias. Additionally, bicarbonate is used for poisoning with agents that cause rhabdomyolysis or severe metabolic acidosis (such as salicylate poisoning), as it helps to correct acidosis and may enhance toxin elimination through urinary alkalinization.

The scientific evidence for these uses comes from clinical studies, case reports, and established toxicology guidelines (e.g., American College of Medical Toxicology, Goldfrank's Toxicologic Emergencies). However, its use is specific to certain poisonings and is not universally beneficial in all toxic exposures. The overall evidence is rated as 4 out of 5 because, while robust for certain indications, it is not applicable to all cases of poisoning. There is little traditional or historical use outside of modern clinical toxicology. The evidence base is bolstered by decades of clinical practice and inclusion in major medical references for emergency management of poisoning.

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