Treatment of Chronic Respiratory Failure and a Role of Acetazolamide

Abstract

Two cases of chronic respiratory failure are presented. One was the case of respiratory acidosis noted upon acute exacerbation of chronic pulmonary emphysema, and the other was the case of chronic bronchitis showing CO₂ narcosis. In the former case, after improvement of the acidosis by drip infusion of sodium bicarbonate, plasma HCO₃^- elevated by sodium bicarbonate was reduced with oral administration of acetazolamide and the patient's condition became stable. In the latter case, administration of acetazolamide reduced plasma HCO₃^- concentration and simultaneously improved the general condition, hypoxia and hypercapnia. Inhalation of O₂ at a low concentration was applied to both cases.
In cases of hypercapnia noted in chronic obstructive lung diseases, administration of acetazolamide is useful to reduce the plasma HCO₃^- level to expect improvement of respiration.