title: Dissociation of renal and respiratory effects of acetazolamide in the critically ill.
abstract: The effects of acetazolamide on renal and erythrocyte carbonic anhydrase were studied in 12 critically ill patients. In the first part of the investigation (n = 6) we examined the renal effects of increasing doses of acetazolamide. The maximal renal excretion of water and bicarbonate was achieved with acetazolamide 2.5-5 mg kg-1 i.v. In the second part (n = 6), the associated respiratory effects of the effective renal dose of acetazolamide 5 mg kg-1 were evaluated. We found a statistically significant 4% decrease in pulmonary carbon dioxide excretion in the 10-min sampling period immediately following the administration of acetazolamide, but thereafter carbon dioxide elimination proceeded at a normal rate. The observed carbon dioxide retention is clinically unimportant, and we recommend acetazolamide as an effective means of eliminating surplus water and bicarbonate in the critically ill.
authors.forename: P
authors.initials: P
authors.lastname: Berthelsen
authors.forename: I
authors.initials: I
authors.lastname: Gøthgen
authors.forename: B
authors.initials: B
authors.lastname: Husum
authors.forename: E
authors.initials: E
authors.lastname: Jacobsen
mesh_terms: D000086:Acetazolamide / Q000494:pharmacology*; D000136:Acid-Base Equilibrium; D000328:Adult; D000368:Aged; D001639:Bicarbonates / Q000652:urine; D002245:Carbon Dioxide / Q000502:physiology; D002257:Carbonic Anhydrase Inhibitors; D003422:Critical Care; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007668:Kidney / Q000187:drug effects*; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D011188:Potassium / Q000097:blood; D012119:Respiration / Q000187:drug effects*; D014556:Urine
chemical_list: D001639:Bicarbonates; D002257:Carbonic Anhydrase Inhibitors; D002245:Carbon Dioxide; D000086:Acetazolamide; D011188:Potassium; D010100:Oxygen