Document Detail


Acetazolamide fails to decrease pulmonary artery pressure at high altitude in partially acclimatized humans.
MedLine Citation:
PMID:  18800957     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In this randomized, double-blind placebo controlled trial our objectives were to determine if acetazolamide is capable of preventing high altitude pulmonary edema (HAPE) in trekkers traveling between 4250 m (Pheriche)\4350 m (Dingboche) and 5000 m (Lobuje) in Nepal; to determine if acetazolamide decreases pulmonary artery systolic pressures (PASP) at high altitude; and to determine if there is an association with PASP and signs and symptoms of HAPE. Participants received either acetazolamide 250 mg PO BID or placebo at Pheriche\Dingboche and were reassessed in Lobuje. The Lake Louise Consensus Criteria were used for the diagnosis of HAPE, and cardiac ultrasonography was used to measure the velocity of tricuspid regurgitation and estimate PASP. Complete measurements were performed on 339 of the 364 subjects (164 in the placebo group, 175 in the acetazolamide group). No cases of HAPE were observed in either study group nor were differences in the signs and symptoms of HAPE found between the two groups. Mean PASP values did not differ significantly between the acetazolamide and placebo groups (31.3 and 32.6 mmHg, respectively). An increasing number of signs and symptoms of HAPE was associated with elevated PASP (p < 0.01). The efficacy of acetazolamide against acute mountain sickness, however, was significant with a 21.9% incidence in the placebo group compared to 10.2 % in the acetazolamide group (p < 0.01). Given the lack of cases of HAPE in either group, we can draw no conclusions about the efficacy of acetazolamide in preventing HAPE, but the absence of effect on PASP suggests that any effect may be minor possibly owing to partial acclimatization during the trek up to 4200 m.
Authors:
Buddha Basnyat; Jenny Hargrove; Peter S Holck; Soni Srivastav; Kshitiz Alekh; Laxmi V Ghimire; Kaushal Pandey; Anna Griffiths; Ravi Shankar; Komal Kaul; Asmita Paudyal; David Stasiuk; Rose Basnyat; Christopher Davis; Andrew Southard; Cathleen Robinson; Thomas Shandley; Dan W Johnson; Ken Zafren; Sarah Williams; Eric A Weiss; Jeremy J Farrar; Erik R Swenson
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  High altitude medicine & biology     Volume:  9     ISSN:  1527-0297     ISO Abbreviation:  High Alt. Med. Biol.     Publication Date:  2008  
Date Detail:
Created Date:  2008-09-19     Completed Date:  2009-01-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100901183     Medline TA:  High Alt Med Biol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  209-16     Citation Subset:  IM; S    
Affiliation:
Nepal International Clinic, Kathmandu, Nepal., Himalayan Rescue Association, Kathmandu, Nepal.
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MeSH Terms
Descriptor/Qualifier:
Acetazolamide / pharmacology*
Adult
Altitude Sickness / drug therapy*,  prevention & control
Blood Pressure / drug effects
Carbonic Anhydrase Inhibitors / pharmacology*
Dose-Response Relationship, Drug
Double-Blind Method
Female
Hemodynamics / drug effects
Humans
Male
Middle Aged
Mountaineering
Nepal
Pulmonary Artery / drug effects
Pulmonary Edema / drug therapy*,  prevention & control
Pulmonary Wedge Pressure / drug effects*
Chemical
Reg. No./Substance:
0/Carbonic Anhydrase Inhibitors; 59-66-5/Acetazolamide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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