Finsterer U, Lühr H G, Wirth A E
Acta Anaesthesiol Scand. 1978;22(4):353-66. doi: 10.1111/j.1399-6576.1978.tb01311.x.
In order to test the relationship between changes in plasma potassium concentration and pH changes of respiratory origin, we produced hypercapnia (mean PaCO2 71 mmHg = 9.5 kPa) in a group of 17 patients and hypocapnia (mean PaCO2 21 mmHg = 2.8 kPa) in another 20 patients during neurolept analgesia and intraabdominal operations. A control group of 19 patients was studied under normocapnia but otherwise identical conditions. During hypercapnia, serum potassium rose, deltaK/deltapH amounting to -0.82, -1.05 and -1.34 after 30, 60 and 90 min, respectively. During hypocapnia, serum potassium decreased, deltaK/deltapH being a little more negative than during hypercapnia (mean values -1.62, -2.44 and -1.60). Red cell potassium concentration decreased in all three groups to a similar extent. Blood lactate levels during hypercapnia decreased to 75% of control and during hypocapnia rose to a maximum of 186% of control. In order to obtain reasonable values for base excess in primarily respiratory acid-base disorders, it is necessary to use nomograms based on in vivo ECF-CO2-titration curves. With this premise, hypercapnia or hypocapnia in our patients was not associated with significant changes in base excess.
为了测试血浆钾浓度变化与呼吸源性pH变化之间的关系，我们在一组17例患者中制造了高碳酸血症（平均动脉血二氧化碳分压[PaCO2] 71 mmHg = 9.5 kPa），并在另一组20例患者中制造了低碳酸血症（平均PaCO2 21 mmHg = 2.8 kPa），这些患者均处于神经安定镇痛和腹腔内手术期间。对19例患者组成的对照组在正常碳酸血症但其他条件相同的情况下进行了研究。在高碳酸血症期间，血清钾升高，30、60和90分钟后的ΔK/ΔpH分别为-0.82、-1.05和-1.34。在低碳酸血症期间，血清钾降低，ΔK/ΔpH比高碳酸血症期间更负一点（平均值为-1.62、-2.44和-1.60）。三组中红细胞钾浓度均有相似程度的降低。高碳酸血症期间血乳酸水平降至对照值的75%，低碳酸血症期间则升至对照值的最大186%。为了在主要的呼吸性酸碱紊乱中获得合理的碱剩余值，有必要使用基于体内细胞外液二氧化碳滴定曲线的列线图。在此前提下，我们患者中的高碳酸血症或低碳酸血症与碱剩余的显著变化无关。
