Abstract
Though buffers are widely used in daily practice, there is little information about their effect on intracellular pH in vivo. In this study, the effects of NH4Cl on intra- and extracellular acid-base equilibria were examined. Intact male Sprague-Dawley rats were infused with 3 mmol NH4Cl per kg body weight. Arterial plasma pH and pCO2 were measured at intervals for six hours. In addition, the "mean whole body (intracellular) pHi", an overall estimate of the intracellular pH (complementary to the in vivo determined arterial plasma pH) was calculated from the distribution of 14C labeled DMO (5,5-dimethyl-2,4-oxazolidinedione). For evaluation of buffering, extra- and intracellular bicarbonate was calculated from the Henderson-Hasselbalch equation. Though a decrease of pHe (extracellular pH) by 0.12 pH units was found just after infusion of NH4Cl, pHi increased over the 6 hours of investigation by 0.08 pH units. Extracellular bicarbonate was reduced but there was little change in intracellular bicarbonate concentration. For the treatment of metabolic alkalosis, therapeutic agents are given to reduce intracellular pH and intracellular bicarbonate concentration.. However, it was found in this study that NH4Cl has no effect on intracellular bicarbonate concentration. In addition, infusion of NH4Cl causes an increase of intracellular pH which cannot be detected by blood-gas measurements. The intracellular pH increase that we have demonstrated may have adverse consequences for patients and raises objections to the use of NH4Cl in the treatment of metabolic alkalosis.
Highlights
Coronary artery disease has been widely considered a “man’s disease” and not a major concern for women
Hyperlipidemia In women, low-density lipoprotein (LDL) cholesterol and total cholesterol levels increase after the age of 55 years and peak between 55 and 65 years of age, about a decade later than in men.High triglyceride levels seem to increase the risk of coronary artery disease in women.[19]
percutaneous coronary intervention (PCI) is generally preferred for patients with milder Coronary artery disease (CAD) burden described as single- or double-vessel diseasewhen symptoms warrant coronary revascularization, in the light of its lower procedural risk and evidence that PCI reduces angina and myocardial ischemia in this subset of patients.The major advantage of PCI is its relative ease of use and avoidance of general anesthesia, thoracotomy, extracorporeal circulation, central nervous system complications, and prolonged convalescence
Summary
Coronary artery disease has been widely considered a “man’s disease” and not a major concern for women. The prevalence of coronary risk factors and the number of cardiovascular deaths have decreased in men—but not in women.[2]
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