CATARINA KIEFE, M.D., Ph.D.
To the editor: Morris and associates' (1) study of bicarbonate therapy in diabetic ketoacidosis contributes important evidence against using bicarbonate. However, we cannot agree that the authors have established that "administration of bicarbonate does not affect recovery outcome variables as compared with those in a control group."
Although the hypothesis of the lack of effect of bicarbonate treatment is consistent with their results and may be true, they have not proved this hypothesis. They may be committing a type-II error with their assertion of no effect (2). In fact, their study suggests a deleterious effect of bicarbonate, with insufficient power
KIEFE C. Bicarbonate Therapy in Severe Diabetic Ketoacidosis. Ann Intern Med. ;106:635–636. doi: 10.7326/0003-4819-106-4-635_2
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Published: Ann Intern Med. 1987;106(4):635-636.
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