Teloh J K, Waack I N, de Groot H
Institute of Physiological Chemistry, University of Duisburg-Essen, University Hospital Essen, Essen, Germany.
Physiol Res. 2017 Sep 22;66(4):615-620. doi: 10.33549/physiolres.933491. Epub 2017 Apr 12.
Recently, we have established a model of severe stepwise normovolemic hemodilution to a hematocrit of 10 % in rats employing three different colloidal volume replacement solutions (Voluven, Volulyte and Gelafundin) that are routinely used in clinical practice at present. We did not see severe dilutional acidosis as to be expected, but a decline in urinary pH. We here looked on further mechanisms of renal acid excretion during normovolemic hemodilution. Bicarbonate, which had been removed during normovolemic hemodilution, was calculated with the help of the Henderson-Hasselbalch equation. The urinary amount of ammonium as well as phosphate was determined in residual probes. The absolute amount of free protons in urine was obtained from the pH of the respective samples. The amount of protons generated during normovolemic hemodilution was approximately 0.6 mmol. During experimental time (5.5 h), distinct urinary ammonium excretion occurred (Voluven 0.52 mmol, Volulyte 0.39 mmol and Gelafundin 0.77 mmol). Proton excretion via the phosphate buffer constituted 0.04 mmol in every experimental group. Excretion of free protons was in the range of 10(-6) mmol. The present data prove that the prompt rise in urinary ammonium excretion is also valid for acute metabolic acidosis originating from severe normovolemic hemodilution.
最近,我们建立了一种大鼠严重逐步等容血液稀释至血细胞比容为10%的模型,采用目前临床实践中常规使用的三种不同胶体容量替代溶液(万汶、聚明胶肽和贺斯)。我们并未观察到预期的严重稀释性酸中毒,而是尿pH值下降。我们在此研究等容血液稀释期间肾脏排酸的进一步机制。借助亨德森-哈塞尔巴尔赫方程计算等容血液稀释期间被清除的碳酸氢盐。在剩余样本中测定尿铵以及磷酸盐的含量。从各个样本的pH值获取尿液中游离质子的绝对量。等容血液稀释期间产生的质子量约为0.6 mmol。在实验期间(5.5小时),出现了明显的尿铵排泄(万汶0.52 mmol,聚明胶肽0.39 mmol,贺斯0.77 mmol)。每个实验组中通过磷酸盐缓冲液的质子排泄量为0.04 mmol。游离质子的排泄量在10^(-6) mmol范围内。目前的数据证明,尿铵排泄迅速增加对于严重等容血液稀释引起的急性代谢性酸中毒同样适用。