Comparison of Arginine Hydrochloride and Acetazolamide for the Correction of Metabolic Alkalosis in Pediatric Patients
| Autor: | Alexandra Oschman, Tracy L. Sandritter, Daniel E. Heble |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Critical Illness Metabolic alkalosis 030204 cardiovascular system & hematology Arginine Gastroenterology 03 medical and health sciences 0302 clinical medicine Refractory Chlorides Internal medicine medicine Serum chloride Humans Pharmacology (medical) In patient 030212 general & internal medicine Carbonic Anhydrase Inhibitors Retrospective Studies Pharmacology ARGININE HYDROCHLORIDE business.industry Metabolic disorder Infant Alkalosis General Medicine Carbon Dioxide medicine.disease Acetazolamide Bicarbonates Endocrinology Treatment Outcome Child Preschool business Fluid replacement medicine.drug |
| Zdroj: | American journal of therapeutics. 23(6) |
| ISSN: | 1536-3686 |
| Popis: | Metabolic alkalosis is a common acid-base disturbance occurring in critically ill pediatric patients. Acetazolamide and arginine hydrochloride are pharmacologic agents used at our institution for patients refractory to first-line therapy or those unable to tolerate fluid replacement. The objective of this retrospective review was to determine if a course of arginine hydrochloride or acetazolamide was more effective at correcting metabolic alkalosis within a 24-hour period. Patients included received a course of acetazolamide or arginine hydrochloride for metabolic alkalosis with a repeat metabolic panel 18-30 hours after treatment initiation. Exclusion criteria consisted of previous treatment with either drug within 24 hours or a documented metabolic disorder. Efficacy was determined by proportion of patients achieving resolution of metabolic alkalosis (treatment success: serum CO230 mmol/L and Cl96 mmol/L). Additionally, mean change in serum bicarbonate and chloride concentrations was assessed. Thirty-four patients met inclusion criteria, 19 patients received acetazolamide and 15 patients received arginine hydrochloride. Treatment success was similar in patients receiving acetazolamide and arginine hydrochloride (37% vs. 7%, P = 0.053). Correction of serum bicarbonate was observed in more patients treated with acetazolamide (42% vs. 7%, P = 0.047). Both groups had a similar increase in mean serum chloride concentration (5.7 ± 5.3 vs. 4.4 ± 4.4 mmol/L, P = 0.458). Mean decrease in serum bicarbonate concentration was equivalent between groups (5.6 ± 5.2 vs. 2.8 ± 4.7, mmol/L, P = 0.110). Acetazolamide and arginine hydrochloride appear to be equally effective in correcting metabolic alkalosis in critically ill pediatric patients. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|