I recently read the paper by Tong et al., which explores the clinical effects of sodium bicarbonate (SOB) therapy in metabolic acidosis, focusing on the interaction between baseline chloride levels and patient survival [1]. Based on a large multi-center ICU database, the authors hypothesize that SOB treatment may benefit hyperchloremic metabolic acidosis. While the study provides valuable insights, some shortcomings need to be noticed to interpret its conclusions better, and future studies could address these shortcomings.
