Bicarbonate: From Physiology to Clinical Practice: Reply

We would like to thank Hess and Long1 for their comments on our article,2 who emphasized the role of acidemia-associated coagulopathy in terms of decreasing fibrinogen concentration, reducing coagulation factors and promoting a state of hypocoagulability. Furthermore, the correction of the state of acidemia with bicarbonate infusion does not correct or alleviate coagulopathy, suggesting that, in the presence of hemorrhagic shock, it is mandatory to avoid or decrease the severity of acidemia and hypothermia to improve outcome.3–5The authors declare no competing interests.