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Experimental Anesthesia, Clinic of Anesthesiology and Surgical Intensive Care Medicine, Campus Virchow-Klinikum, Charité, D-13353 Berlin, Germany
Acute hypoxia causes hyperventilation
and respiratory alkalosis, often combined with increased diuresis and
sodium, potassium, and bicarbonate excretion. With a low sodium intake,
the excretion of the anion bicarbonate may be limited by the lower
excretion rate of the cation sodium through activated sodium-retaining
mechanisms. This study investigates whether the short-term renal
compensation of hypoxia-induced respiratory alkalosis is impaired by a
low sodium intake. Nine conscious, tracheotomized dogs were studied twice either on a low-sodium (LS = 0.5 mmol sodium · kg
body wt
1 · day
1) or high-sodium
(HS = 7.5 mmol sodium · kg body
wt
1 · day
1) diet. The dogs breathed
spontaneously via a ventilator circuit during the experiments: first
hour, normoxia (inspiratory oxygen fraction = 0.21); second to
fourth hour, hypoxia (inspiratory oxygen fraction = 0.1). During
hypoxia (arterial PO2 34.4 ± 2.1 Torr),
plasma pH increased from 7.37 ± 0.01 to 7.48 ± 0.01 (P < 0.05) because of hyperventilation (arterial
PCO2 25.6 ± 2.4 Torr). Urinary pH and
urinary bicarbonate excretion increased irrespective of the sodium
intake. Sodium excretion increased more during HS than during LS,
whereas the increase in potassium excretion was comparable in both
groups. Thus the quick onset of bicarbonate excretion within the first
hour of hypoxia-induced respiratory alkalosis was not impaired by a low
sodium intake. The increased sodium excretion during hypoxia seems to
be combined with a decrease in plasma aldosterone and angiotensin II in
LS as well as in HS dogs. Other factors, e.g., increased mean arterial blood pressure, minute ventilation, and renal blood flow, may have contributed.
hypoxia; acid-base balance; hormones; short-term renal compensation
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