PT - JOURNAL ARTICLE AU - E Carrion AU - J H Hertzog AU - M D Medlock AU - G J Hauser AU - H J Dalton TI - Use of acetazolamide to decrease cerebrospinal fluid production in chronically ventilated patients with ventriculopleural shunts AID - 10.1136/adc.84.1.68 DP - 2001 Jan 01 TA - Archives of Disease in Childhood PG - 68--71 VI - 84 IP - 1 4099 - http://adc.bmj.com/content/84/1/68.short 4100 - http://adc.bmj.com/content/84/1/68.full SO - Arch Dis Child2001 Jan 01; 84 AB - Acetazolamide (ACTZ), a carbonic anhydrase inhibitor, has been shown to decrease cerebrospinal fluid (CSF) production in both in vivo and in vitro animal models. We report two children with hydrocephalus who experienced multiple shunt failures, and who had externalised ventriculostomy drains (EVD) prior to ventriculopleural shunt placement. The effects of increasing doses of ACTZ on CSF production and subsequent tolerance to ventriculopleural shunts were evaluated. The patients had a 48% and a 39% decrease in their EVD CSF output when compared to baseline with maximum ACTZ dose of 75 mg/kg/day and 50 mg/kg/day, respectively (pā€‰<ā€‰0.05). This is the first report of change in CSF volume in children after extended treatment with ACTZ. ACTZ treatment in mechanically ventilated paediatric patients with hydrocephalus may improve tolerance of ventriculopleural shunts and minimise respiratory compromise. Potassium and bicarbonate supplements are required to correct metabolic disturbances.