Document Detail


Effectiveness of acetazolamide for reversal of metabolic alkalosis in weaning COPD patients from mechanical ventilation.
MedLine Citation:
PMID:  20217045     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate the effects of a single daily dose of acetazolamide (ACET) on metabolic alkalosis and respiratory parameters in weaning chronic obstructive pulmonary disease (COPD) patients from invasive mechanical ventilation. DESIGN: Case-control study. SETTING: An 18-bed intensive care unit (ICU) in a university hospital. PATIENTS: Twenty-six intubated COPD patients with mixed metabolic alkalosis (serum bicarbonate >26 mmol/l and arterial pH >or=7.38) were compared with a historical control group (n = 26) matched for serum bicarbonate, arterial pH, age, and severity of illness at admission to ICU. ACET administration (500 mg intravenously) was monitored daily according to arterial blood gas analysis from readiness to wean until extubation. RESULTS: ACET was administered 4 (1-11) days throughout the weaning period. Patients with ACET treatment significantly decreased their serum bicarbonate (p = 0.01 versus baseline) and arterial blood pH (p < 0.0001), increased their PaO(2)/FiO(2) ratio (p = 0.04), but did not change their PaCO(2) (p = 0.71). Compared with matched controls, administration of ACET did not improve arterial blood gas and respiratory parameters except PaO(2)/FiO(2) ratio (p = 0.03). ACET patients and their matched controls had similar duration of weaning. Extubation success rate was not significantly different between groups, and causes of reintubation were comparable. CONCLUSIONS: ACET used at the dosage of 500 mg per day reduces metabolic alkalosis but has no benefit in terms of improving PaCO(2) or respiratory parameters in weaning COPD patients from mechanical ventilation.
Authors:
Christophe Faisy; Amel Mokline; Olivier Sanchez; Jean-Marc Tadié; Jean-Yves Fagon
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Publication Detail:
Type:  Journal Article     Date:  2010-03-09
Journal Detail:
Title:  Intensive care medicine     Volume:  36     ISSN:  1432-1238     ISO Abbreviation:  Intensive Care Med     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-07     Completed Date:  2010-07-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  859-63     Citation Subset:  IM    
Affiliation:
Medical Intensive Care Unit, Hôpital Européen Georges Pompidou, Université Paris-Descartes, 20 rue Leblanc, Paris Cedex 15, France. christophe.faisy@egp.aphp.fr
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MeSH Terms
Descriptor/Qualifier:
Acetazolamide / administration & dosage*
Aged
Alkalosis / blood,  drug therapy*,  etiology
Bicarbonates / blood
Carbonic Anhydrase Inhibitors / administration & dosage*
Case-Control Studies
Female
Humans
Infusions, Intravenous
Male
Oxygen / blood
Partial Pressure
Pulmonary Disease, Chronic Obstructive / blood,  therapy*
Treatment Outcome
Ventilator Weaning / adverse effects*,  methods
Ventilators, Mechanical / adverse effects
Chemical
Reg. No./Substance:
0/Bicarbonates; 0/Carbonic Anhydrase Inhibitors; 59-66-5/Acetazolamide; 7782-44-7/Oxygen

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


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