Abstract
SUMMARY A study was undertaken to evaluate the effect of the carbonic anhydrase inhibitor, acetazolamide, on postperfusion metablic alkalosis. In a series of twenty patients undergoing singly Starr valve replacement for acquired heart disease, ten patients acted as controls while the remainder received acetazolamide 250 mg on termination of surgery and again on the morning of the first postoperative day. Mean postoperative base excess and pH of urine in the control goup showed a moderate metabolic alkalosis and progressive urinary acidity throughout the period of study. In the acetazoamide group, mean base excess was significantly less and mean pH of urine significantly higher 6–7 hours after operation and in the first postoperative day. Confirmation of the urine pH findings was obtained from collections of urine taken at specified intervals. In general, the typical postoperative pattern of low sodium and chloride and increased potassium excretion was observed in the urine collections. The relationship of the urinary electroytes is discussed. It is suggested that acetazolamide therapy is a useful method of reducing an undue elevation of postoperative base excess.
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