Acetazolamide for Respiratory Failure in Combination With Metabolic Alkalosis

University of Oslo School of Pharmacy

Status and phase

Completed

Phase 4

Conditions

Respiratory Insufficiency

Alkalosis

Treatments

Drug: Placebo

Drug: Acetazolamide

Study type

Interventional

Funder types

Other

Identifiers

NCT00222534

AREMA

Details and patient eligibility

About

Respiratory failure is a common consequence of chronic obstructive pulmonary disease (COPD). A concurrent metabolic alkalosis may worsen the respiratory failure, as a higher pH in blood (and thus in cerebrospinal fluid) results in a weaker respiratory drive. Use of diuretics is the most common cause of metabolic alkalosis.

When a patient with an acute exacerbation of a respiratory failure is also alkalotic, there are (at least theoretical) reasons to lower the pH in order to increase the respiratory drive. Among other alternatives, the drug acetazolamide can be used for this purpose.

In some hospitals there is a tradition for the use of acetazolamide on this indication, but any evidence for the effect of such a treatment is rather weak.

Thus, the aim of this trial is to evaluate the effect of acetazolamide as an adjuvant treatment for hospitalized patients with acute exacerbation of respiratory failure in combination with metabolic alkalosis.

Enrollment

70 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Arterial pO2 8 kPa or lower, and arterial pCO2 7 kPa or higher.
Base Excess 8 mmmol/l or higher.
Written informed consent

Exclusion criteria

Acetazolamide treatment regarded as obviously indicated or obviously contraindicated
Already using acetazolamide
Moribund patient
Unable to give fully informed consent
Allergy towards the tablet content or unable to swallow the tablets
Pregnant or breast-feeding