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To the Editor: As an intensive care unit director, I read the study by Dr Merten and colleagues with great interest.¹ However, as a clinician caring for outpatients, the possibility of oral bicarbonate therapy is important, particularly with its high oral bioavailability. Providing patients with a pre-procedure regimen of bicarbonate pills plus water followed by the same post-procedure treatment may result in efficacy equal to intravenous therapy, leading to a more rapid discharge from the hospital setting.

Robert E. Siegel, MD
robert.siegel@med.va.gov
Critical Care Center
Bronx VA Medical Center
Bronx, NY

1. Merten GJ, Burgess WP, Gray LV, et al. Prevention of contrast-induced nephropathy with sodium bicarbonate: a randomized controlled trial. JAMA. 2004;291:2328-2334. FREE FULL TEXT

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2004;292:1428.

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