Effect of acute metabolic acid/base shifts on the human airway calibre

Abstract

Acute metabolic alkalosis (NaHCO3), acidosis (NH4Cl), and placebo (NaCl) were induced in 15 healthy volunteers (12 females, median age 34 (range 24–56) years) in a double blind, placebo controlled study to evaluate the presence of the effects on airway calibre. Acid–base shifts were determined by capillary blood gas sampling. Measurements were performed at the maximal acid–base shift, 90 min after intervention. Airway resistance (Raw) and specific airway conductance (sGaw), were evaluated, as primary variables, pre and post intervention. Secondary variables, including bronchial responsiveness to histamine, maximal respiratory mouth pressures and grip strength, were evaluated post intervention. In alkalosis, base excess (BE) increased from –0.3 (−3.0–1.9) to 3.0 (1.0–4.8) mmol/l and pH increased from 7.41 (7.37–7.43) to 7.44 (7.39–7.47) (both P<0.01), accompanied by an increase in PaCO2: 4.7 (4.0–5.7) to 5.0 (4.7–6.1) kPa (P<0.05). Raw increased from 0.156 (0.134–0.263) to 0.169 (0.132–0.271) kPa s/L (P<0.05), sGaw decreased, but this was not statistically significantly. In acidosis, BE decreased from −0.2 (−2.0–2.2) to –3.5 (−6.3–1.1) mmol/l and pH decreased from 7.41 (7.39–7.45) to 7.36 (7.31–7.40) (both P<0.01), accompanied by a non-significant decrease in PaCO2. Changes in Raw and sGaw were contrary to those in alkalosis, but did not reach statistical significance. Acute metabolic acid–base shifts mildly influence the airway calibre in healthy human subjects.