Acetazolamide for Respiratory Failure in Combination With Metabolic Alkalosis
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.
|Study Design:||Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Investigator)
Primary Purpose: Treatment
|Official Title:||Acetazolamide for Respiratory Failure in Combination With Metabolic Alkalosis|
- Partial pressure of oxygen in arterial blood on the 5th day of treatment (without extra oxygen)
- Change in partial pressure of oxygen from start of treatment to the fifth day of treatment
- Partial pressure of carbon dioxide in arterial blood on the 5th day of treatment.
- Change in partial pressure of carbon dioxide from start of treatment to the fifth day of treatment
- Intrahospital deaths
- Use of mechanical ventilation
- Length of stay
- Side effects
|Study Start Date:||January 2002|
|Study Completion Date:||December 2009|
|Primary Completion Date:||December 2009 (Final data collection date for primary outcome measure)|
Acetazolamide 250 mg Three times a day for five days
Placebo Comparator: Placebo
Placebo, one tablet Three times a day for five days
|Department of Respiratory Medicine, Haukeland University Hospital|
|Department of Internal Medicine, Sorlandet Sykehus Kristiansand|
|Department of Internal Medicine, Aker University Hospital|
|Oslo, Norway, 0514|
|Ullevaal University Hospital, Dept. of Respiratory Medicine|
|Oslo, Norway, NO-0407|
|Department of Internal Medicine, St.Olav's Hospital|
|Principal Investigator:||Torgeir B Wyller, MD, PhD||Department of Geriatric Medicine, Ullevaal University Hospital, Oslo, Norway|