D

Intravenous sodium bicarbonate is an alkalinizing agent that directly buffers excess hydrogen ions and raises arterial pH, making it the standard pharmacologic treatment when severe metabolic acidosis develops during prolonged CPR. Glucose and epinephrine improve energy supply or perfusion but do not correct acid–base status. [Martinez, 1979, PMID 44382; Niemann, 1984, PMID 6089619]