Many people, particularly in developing countries, are poisoned by organophosphorus pesticides (OPs) used in agriculture or for killing insects in the home. Poisoning may be accidental or intentional. Even when the usual antidotes are given, 10 to 20% of those poisoned still die. Research in animals has suggested that use of sodium bicarbonate (baking soda) or similar chemicals which make the blood alkaline might save people poisoned by OPs.
The review authors looked for studies in which such chemicals were given to OP poisoned patients, to see how effective the treatment is. They sought randomised controlled trials, a type of research study in which one group of patients is given one treatment, while a similar group (the control group) is given a different treatment.
The authors found eight studies but only two small randomised controlled trials, one using higher dose sodium bicarbonate and the other a lower dose. Only the trial using higher dose sodium bicarbonate, which included 53 participants, showed a slight benefit from using sodium bicarbonate in conjunction with standard treatment for OP poisoning. This study does not provide enough evidence to recommend routine clinical use of sodium bicarbonate. There are hundreds of different kinds of OPs so treatment may vary based on the type of poisoning as well as the severity of the poisoning. More research needs to be done to determine the best treatment for poisoning with OPs in various situations.