Chest
Hormonal Abnormalities Affecting Sodium and Water Balance in Acute Respiratory Failure Due to Chronic Obstructive Lung Disease
Section snippets
MATERIALS AND METHODS
The studies were performed on ten patients, all men, mean age 57 ± 2 SE years, who presented with acute respiratory failure and met the following criteria:
- (a)
Chronic obstructive lung disease by standard tests of pulmonary function:4 total lung capacity (TLC) and specific airway conductance (SGaw) by body plethysmography; forced one second expiratory volume (FEV1) and forced vital capacity (FVC) by SRL computerized spirometer;
- (b)
Acute hypercapneic respiratory failure as evidenced by abnormal
RESULTS
The ten patients were clearly separable into two distinct groups based on changes in sodium and water balances during therapy (Fig 1). Group A (n = 6) exhibited a sustained sodium and water diuresis which began within 24 to 48 hours. Each of the patients in this group lost more than 2 kg of body weight over the six days of observation and treatment. In each case, this weight loss was associated with a cumulative net negative balance for sodium and water in excess of 200 mEq and 2,000 ml,
DISCUSSION
Our studies indicate that the disturbance in sodium and water metabolism associated with acute respiratory failure in patients with COLD is not a single entity. Rather, it can be separated into at least two forms which differ in their response to therapy, as well as in the incidence of severity of underlying hormonal abnormalities. These two forms are not clearly set apart in all their aspects and may, in fact, ultimately prove to be two phases of a pathologic continuum. Nevertheless, their
ACKNOWLEDGMENT
The authors wish to acknowledge with gratitude the technical assistance of Carolyn Magnes and Mary Beth
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Cited by (0)
These studies were supported in part by United States Public Health Service grant HL 14159—the Specialized Center of Research (SCOR) in Hypertension.
Manuscript received March 14; revision accepted June 29.