title: Impact of acetazolamide use in severe exacerbation of chronic obstructive pulmonary disease requiring invasive mechanical ventilation.
abstract: OBJECTIVE
  To analyse the impact of acetazolamide (ACET) use in severe acute decompensation of chronic obstructive pulmonary disease requiring mechanical ventilation and intensive care unit (ICU) admission.
  
  
  METHODS
  Retrospective pair-wise, case-control study with 1:1 matching. Patients were defined as cases when they had received acetazolamide (500 mg per day) and as controls when they did not received it. Patients were matched according to age, severity on admission (pH, PaO2/FiO2 ratio) and SAPSII score. Our primary endpoint was the effect of ACET (500 mg per day) on the duration of mechanical ventilation. Our secondary endpoints were the effect of ACET on arterial blood gas parameters, ICU length of stay (LOS) and ICU mortality.
  
  
  RESULTS
  Seventy-two patients were included and equally distributed between the two studied groups. There were 66 males (92%). The mean age (± SD) was 69.7 ± 7.4 years ranging from 53 to 81 years. There were no differences between baseline characteristics of the two groups. Concomitant drugs used were also not significantly different between two groups. Mean duration of mechanical ventilation was not significantly different between ACET(+) and ACET(-) patients (10.6±7.8 days and 9.6±7.6 days, respectively; P = 0.61). Cases had a significantly decreased serum bicarbonate, arterial blood pH, and PaCO2 levels. We did not found any significant difference between the two studied groups in terms of ICU LOS. ICU mortality was also comparable between ACET(+) and ACET(-) groups (38% and 52%, respectively; P = 0.23).
  
  
  CONCLUSIONS
  Although our study some limitations, it suggests that the use of insufficient acetazolamide dosage (500 mg/d) ACET (500 mg per day) has no significant effect on the duration of mechanical ventilation in critically ill COPD patients requiring invasive mechanical ventilation. Our results should be confirmed or infirmed by further studies.
authors: Intensive Care Unit, Habib Bourguiba University Hospital, Sfax, Tunisia.
authors: Mabrouk
authors: M
authors: Bahloul
authors: Intensive Care Unit, Habib Bourguiba University Hospital, Sfax, Tunisia.
authors: Anis
authors: A
authors: Chaari
authors: Intensive Care Unit, Habib Bourguiba University Hospital, Sfax, Tunisia.
authors: Ahmed
authors: A
authors: Tounsi
authors: Intensive Care Unit, Habib Bourguiba University Hospital, Sfax, Tunisia.
authors: Olfa
authors: O
authors: Turki
authors: Intensive Care Unit, Habib Bourguiba University Hospital, Sfax, Tunisia.
authors: Kamilia
authors: K
authors: Chtara
authors: Intensive Care Unit, Habib Bourguiba University Hospital, Sfax, Tunisia.
authors: Chokri Ben
authors: CB
authors: Hamida
authors: Intensive Care Unit, Habib Bourguiba University Hospital, Sfax, Tunisia.
authors: Hatem
authors: H
authors: Ghadhoune
authors: Intensive Care Unit, Habib Bourguiba University Hospital, Sfax, Tunisia.
authors: Hassen
authors: H
authors: Dammak
authors: Intensive Care Unit, Habib Bourguiba University Hospital, Sfax, Tunisia.
authors: Hedi
authors: H
authors: Chelly
authors: Intensive Care Unit, Habib Bourguiba University Hospital, Sfax, Tunisia.
authors: Mounir
authors: M
authors: Bouaziz
keywords: Acute decompensation; acetazolamide; chronic obstructive pulmonary disease; outcome; weaning