کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
5558198 1561079 2017 8 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Effects of early administration of acetazolamide on the duration of mechanical ventilation in patients with chronic obstructive pulmonary disease or obesity-hypoventilation syndrome with metabolic alkalosis. A randomized trial
ترجمه فارسی عنوان
اثرات تجویز اولیه استازولامید بر مدت زمان تهویه مکانیکی در بیماران مبتلا به بیماری مزمن انسدادی ریوی یا سندرم چاقی-هیپوفنتایالات با آلکالوز متابولیک. یک آزمایش تصادفی
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی پزشکی ریوی و تنفسی
چکیده انگلیسی

BackgroundMetabolic alkalosis (MA) inhibits respiratory drive and may delay weaning from mechanical ventilation (MV). MA is common in CO2-retainer patients that need MV. Acetazolamide (ACTZ) decreases serum bicarbonate concentration and stimulates respiratory drive. This study evaluated the effects of ACTZ on the duration of MV in patients with MA and COPD or obesity hypoventilation syndrome (OHS) intubated with acute respiratory failure.MethodsMulticenter, randomized, controlled, double-blind study, with COPD or OHS patients with MV < 72 h and initial bicarbonate >28 mmol/L and pH > 7.35. Test-treatment, ACTZ 500 mg or placebo, was daily administered if pH > 7.35 and bicarbonate >26 mmol/L. Clinical, respiratory and laboratory parameters were recorded.Results47 patients (36 men) were randomized. There were no significant differences between groups in comorbidities, baseline characteristics or arterial blood gases at inclusion. The mean difference in the duration of MV between placebo and ACTZ group was 1.3 days (95%CI, −2.1-4.8; p = 0.44). Kaplan-Meier curves showed no differences in the duration of MV (Log-Rank p = 0.41). Between-group comparison of estimated marginal means (CI 95%) during MV were, respectively: PaCO2 55 (51-59) vs 48 (47-50) mm Hg, p = 0.002; bicarbonate concentration 34 (32-35) vs 29 (28-30) mmol/L, p < 0.0001; and minute volume 9.7 (8.9-10.4) vs 10.6 (9.2-12.0) L/min, p = 0.26. There were no severe adverse effects with ACTZ administration.ConclusionsAmong patients with MA and COPD or OHS, early treatment with ACTZ did not shorten significantly the duration of MV compared with placebo.Trial registryclinical.trials.gov; NCT01499485; URL:.www.clinicaltrials.gov

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Pulmonary Pharmacology & Therapeutics - Volume 44, June 2017, Pages 30-37
نویسندگان
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