Abstract
The extracellular acid-base state and renal response to chronic hypercarbia and hypoxaemia have been studied in patients with chronic bronchitis. The results demonstrate that deviations in extracellular hydrogen ion concentrations are frequently present when the arterial carbon dioxide tension exceeds 65 mm Hg, and in some patients incomplete correction of the extracellular pH was found at much lower CO2 tensions. The increase in net acid excretion which results from both acute and chronic CO2 retention is almost entirely in the form of NH4+, which appears to be closely related to the PacO2 and/or arterial pH, and was found to be uninfluenced by prolonged relief of hypoxaemia. The possibility that impairment of ammonia production or excretion might occur in patients with chronic bronchitis during acute exacerbations of their illness receives some support from studies carried out during the administration of ammonium chloride.
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