Acetazolamide for Respiratory Failure in Combination With Metabolic Alkalosis
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Purpose
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.
| Condition | Intervention | Phase |
|---|---|---|
|
Respiratory Insufficiency Alkalosis |
Drug: Acetazolamide |
Phase 4 |
| Study Type: | Interventional |
| 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
| Estimated Enrollment: | 90 |
| Study Start Date: | January 2002 |
| Study Completion Date: | December 2009 |
| Primary Completion Date: | December 2009 (Final data collection date for primary outcome measure) |
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
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
Contacts and Locations| Norway | |
| Department of Respiratory Medicine, Haukeland University Hospital | |
| Bergen, Norway | |
| Department of Internal Medicine, Sorlandet Sykehus Kristiansand | |
| Kristiansand, Norway | |
| 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 | |
| Trondheim, Norway | |
| Principal Investigator: | Torgeir B Wyller, MD, PhD | Department of Geriatric Medicine, Ullevaal University Hospital, Oslo, Norway |
More Information
No publications provided
| ClinicalTrials.gov Identifier: | NCT00222534 History of Changes |
| Other Study ID Numbers: | AREMA |
| Study First Received: | September 14, 2005 |
| Last Updated: | March 4, 2010 |
| Health Authority: | Norway: Norwegian Medicines Agency |
Keywords provided by University of Oslo School of Pharmacy:
|
Respiratory Insufficiency Alkalosis |
Additional relevant MeSH terms:
|
Alkalosis Respiratory Insufficiency Acid-Base Imbalance Metabolic Diseases Respiration Disorders Respiratory Tract Diseases Acetazolamide Anticonvulsants Central Nervous System Agents |
Therapeutic Uses Pharmacologic Actions Carbonic Anhydrase Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Diuretics Natriuretic Agents Physiological Effects of Drugs Cardiovascular Agents |
ClinicalTrials.gov processed this record on May 19, 2013