Clinical Patho-Physiological Study on the Effect of Induced Hypoxemia of Electrolyte Metabolism (Na<SUP>+</SUP>, K<SUP>+</SUP>).

Abstract

In studies of electrolyte metabolism, there are relatively many reports on in vitro and animal experiments, but hardly no reports are seen of clinical studies on the effect of acute induced hypoxemia on electrolyte metabolism. Above all, no reports are found on a clinical patho-physiological study of the effect of acute induced hypoxemia on electrolyte metabolism (Na+, K+) of the liver by means of hepatic venous catheterization.Therefore, in order to make clear the influence of acute induced hypoxemia upon the electrolyte metabolism in the liver, the author measured the electrolytes(Na+, K+) of the systemic arterial and hepatic venous plasma of healthy subjects and those with liver diseases before and during low oxygen inhalation.Methods and Materials.The inhalation of 10% O2 for 20 minutes was accomplished according to the original Levy's method during a retsing and fasting state.The subjects examined are : Group 1 : Healthy, …9 cases.Group 2 : Light or moderate pulmonary tuberculosis, …14 cases.Group 3 : Cardiovascular diseases, …12 caess.(Essential hypertension 11 cases, and Compensated mitral stenosis 1 case.)Group 4 : Liver diseases, …10 cases.(Acute hepatitis in the convalescent stage 4 cases, chronic hepatitis 4 cases, Banti's syndrome 1 case and hepatic cirrhosis 1 case.)In these 45 cases, samples of systemic arterial blood were taken before and during acute induced hypoxemia, above mentioned.The hepatic venous catheterization was performed in the following 18 cases and samples of the systemic arterial blood and the hepatic venous blood were taken before and dnring the acute incuced hypoxemia.A. Control Group (9 cases) : Healthy…3 cases, Arteriosclerosis…1 case, Gastritis…1 case, Pulmonary tuberculosis, …3 cases, Compensated mitral stenosis, …1 case, B. Group with liver diseases. (9 cases) : Acute hepatitis in the convalescent stage, …4 cases, Chronic hepatitis, …3 cases, Banti's syndrome…1 case, Hepatic cirrhosis…1 case.The measurement of electrolytes (Na+, K+) was accomplished by the S. Shibata's method by utilizing a flamephotometer.Furthermore, the blood gas (Van Slyke method), glucose (Somogyi method), lacate (Hydroxybiphenyl-hydrazine method), pyruvate (Dinitrophenyl-hydrazine method) and the estimated hepatic blood flow (E.H.B.F., by the Bradly method) were measured.Results and Conclusions.I. SODIUM AND POTASSIUM LEVELS OF THE SYSTEMIC ARTEIRAL PLASMA.1) In the resting and fasting state, the sodium level is elevated statistically insignificantly in groups 2 and 3 as compared with the healthy group, and statistically signiffcantly (p<0.02) in group 4.The potassium level is lowered significantly (p<0.05) in group 4.2) The effect of induced hypoxemia : The level of sodium revealed a significant increase (p<0.01) after 15 to 20 minutes. The potassium level revealed a significant decrease (p<0.01) after 5 minutes of hypoxia, an earlier change than the sodium. Further decrease of the potassium level was seen after 15 and 20 minutes.3)When the effect of the oxygen want on the level of arterial plasma sodium and potassium was compared between the healthy and each diseased group, the level of potassium distinctly decreased in each group but the level of sodium increased clearly only in the liver diseased group.4) Thus, the effects of induced hypoxemia is an increase of the level of arterial plasma sodium and a decrease of the level of potassium, and these changes are similar to those introduced by the administration of adrenocortical hormone or the subcutaneous injection of adrenaline. The author makes the supposition from these results, that the stress from the acute induced hypoxemia is related with the pituitary-adrenocortical system.II. [the rest omitted]