A systematic review published in Thorax examines the use of acetazolamide in respiratory failure complicated by metabolic alkalosis in patients with chronic obstructive pulmonary disease (COPD) or obesity hypoventilation syndrome. The researchers conducted a thorough search of relevant databases and identified four randomized controlled trials involving 504 patients, all of whom had COPD.

The study findings suggest that acetazolamide does not significantly impact mortality rates or the duration of ventilatory support in these patients. The analysis showed no statistically significant difference in mortality risk between the acetazolamide and placebo groups. Similarly, the duration of ventilatory support did not differ significantly between the two groups.

While the results indicate limited effectiveness of acetazolamide in managing respiratory failure with metabolic alkalosis, the authors note the need for larger trials to fully assess potential benefits or harms associated with this treatment

Read more: https://thorax.bmj.com/content/early/2023/05/22/thorax-2023-219988