Q: Acetazolamide is an effective way to counteract metabolic alkalosis in patients with acute exacerbation of COPD who requires intubation?
Despite theoretical benefit, acetazolamide failed to show any major impact in acute exacerbation of COPD. In ICUs, these patients frequently go into metabolic alkalosis due to nasogastric (NG) suctioning, diuretic and steroid use. Metabolic alkalosis may lead to suppression of central respiratory drive. Unfortunately, acetazolamide is not of much help in reducing days on ventilators.
1. Faisy C, Meziani F, Planquette B, et al. Effect of Acetazolamide vs Placebo on Duration of Invasive Mechanical Ventilation Among Patients With Chronic Obstructive Pulmonary Disease: A Randomized Clinical Trial. JAMA 2016; 315:480.
2. Bahloul M, Chaari A, Tounsi A, et al. Impact of acetazolamide use in severe exacerbation of chronic obstructive pulmonary disease requiring invasive mechanical ventilation. Int J Crit Illn Inj Sci 2015; 5:3.