Abstract
Typical EKG changes associated with hyperkalemla due to renal shut-down following cardiogenic shock in a neonate with coarctatlon were reversed by the inadvertent induction of respiratory alkalosis in a newborn on a respirator.
It therefore seemed reasonable to determine in dogs whether manipulation of acid base balance by respirator could reverse the hyperkalemia and acidosis associated with acute renal failure. Eight dogs anesthetized with pentobarbital were intubated with cuffed endotracheal tubes. Both ureters were then ligated and .15 N HCl was Infused IV at 5 ml./min. until a partially compensated metabolic acidemia associated with a pH of approximately 7.0 and a PCO2 of 20-24 mm Hg ensued. 90 minutes after the end of the infusion, serum potassium values had risen to 8 mEq/L from a pre-acid value of 5 mEq/L. A volume controlled respirator was then used to triple the dogs' existing respiratory minute volume. Within 120-180 minutes as the PCO2 dropped, in general, to 10 mm Hg, or below, the blood pH returned to approximately 7.4 and the serum potassium concentration to pre-acid levels. Serum potassium concentration remained normal for the 3 to 6 hour duration of hyperventilatlon.
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James, O., Green, R., Levkoff, A. et al. Reversing Acidotic Hyperkalemia of Acute Renal Shut-Down by Artificial Hyperventilation. Pediatr Res 8, 456 (1974). https://doi.org/10.1203/00006450-197404000-00694
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DOI: https://doi.org/10.1203/00006450-197404000-00694
