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Acetazolamide: a second wind for a respiratory stimulant in the intensive care unit?
Patients with chronic obstructive pulmonary disease (COPD) are affected by episodes of respiratory exacerbations, some of which can be severe and may necessitate respiratory support. Prolonged invasive mechanical ventilation is associated with increased mortality rates. Persistent failure to discont...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3580678/ https://www.ncbi.nlm.nih.gov/pubmed/22866939 http://dx.doi.org/10.1186/cc11323 |
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author | Heming, Nicholas Urien, Saïk Faisy, Christophe |
author_facet | Heming, Nicholas Urien, Saïk Faisy, Christophe |
author_sort | Heming, Nicholas |
collection | PubMed |
description | Patients with chronic obstructive pulmonary disease (COPD) are affected by episodes of respiratory exacerbations, some of which can be severe and may necessitate respiratory support. Prolonged invasive mechanical ventilation is associated with increased mortality rates. Persistent failure to discontinue invasive mechanical ventilation is a major issue in patients with COPD. Pure or mixed metabolic alkalosis is a common finding in the intensive care unit (ICU) and is associated with a worse outcome. In patients with COPD, the condition is called post-hypercapnic alkalosis and is a complication of mechanical ventilation. Reversal of metabolic alkalosis may facilitate weaning from mechanical ventilation of patients with COPD. Acetazolamide, a non-specific carbonic anhydrase inhibitor, is one of the drugs employed in the ICU to reverse metabolic alkalosis. The drug is relatively safe, undesirable effects being rare. The compartmentalization of the different isoforms of the carbonic anhydrase enzyme may, in part, explain the lack of evidence of the efficacy of acetazolamide as a respiratory stimulant. Recent findings suggest that the usually employed doses of acetazolamide in the ICU may be insufficient to significantly improve respiratory parameters in mechanically ventilated patients with COPD. Randomized controlled trials using adequate doses of acetazolamide are required to address this issue. |
format | Online Article Text |
id | pubmed-3580678 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-35806782013-08-07 Acetazolamide: a second wind for a respiratory stimulant in the intensive care unit? Heming, Nicholas Urien, Saïk Faisy, Christophe Crit Care Viewpoint Patients with chronic obstructive pulmonary disease (COPD) are affected by episodes of respiratory exacerbations, some of which can be severe and may necessitate respiratory support. Prolonged invasive mechanical ventilation is associated with increased mortality rates. Persistent failure to discontinue invasive mechanical ventilation is a major issue in patients with COPD. Pure or mixed metabolic alkalosis is a common finding in the intensive care unit (ICU) and is associated with a worse outcome. In patients with COPD, the condition is called post-hypercapnic alkalosis and is a complication of mechanical ventilation. Reversal of metabolic alkalosis may facilitate weaning from mechanical ventilation of patients with COPD. Acetazolamide, a non-specific carbonic anhydrase inhibitor, is one of the drugs employed in the ICU to reverse metabolic alkalosis. The drug is relatively safe, undesirable effects being rare. The compartmentalization of the different isoforms of the carbonic anhydrase enzyme may, in part, explain the lack of evidence of the efficacy of acetazolamide as a respiratory stimulant. Recent findings suggest that the usually employed doses of acetazolamide in the ICU may be insufficient to significantly improve respiratory parameters in mechanically ventilated patients with COPD. Randomized controlled trials using adequate doses of acetazolamide are required to address this issue. BioMed Central 2012 2012-08-07 /pmc/articles/PMC3580678/ /pubmed/22866939 http://dx.doi.org/10.1186/cc11323 Text en Copyright ©2012 BioMed Central Ltd |
spellingShingle | Viewpoint Heming, Nicholas Urien, Saïk Faisy, Christophe Acetazolamide: a second wind for a respiratory stimulant in the intensive care unit? |
title | Acetazolamide: a second wind for a respiratory stimulant in the intensive care unit? |
title_full | Acetazolamide: a second wind for a respiratory stimulant in the intensive care unit? |
title_fullStr | Acetazolamide: a second wind for a respiratory stimulant in the intensive care unit? |
title_full_unstemmed | Acetazolamide: a second wind for a respiratory stimulant in the intensive care unit? |
title_short | Acetazolamide: a second wind for a respiratory stimulant in the intensive care unit? |
title_sort | acetazolamide: a second wind for a respiratory stimulant in the intensive care unit? |
topic | Viewpoint |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3580678/ https://www.ncbi.nlm.nih.gov/pubmed/22866939 http://dx.doi.org/10.1186/cc11323 |
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