Electrolyte excretion in respiratory failure.

Patients with chronic emphysema and pulmonary insufficiency commonly arrive at a new steady state in which the carbon dioxide pressure in the blood is increased and the pH lowered; this situation can be prolonged for months during which these patients must be in acid-base balance. This equilibrated state of mild respiratory acidosis is, at times, upset by complicating pneumonitis which aggravates the acidosis; this later returns to its previous mild degree, and observations have been made in patients recovering from an acute episode superimposed on chronic lung disease. It was hoped that changes in renal function would be more easily apparent when the degree of acidosis was changing than when it was in equilibrium. In some of these patients the effect of a mild superimposed metabolic acidosis induced by ammonium chloride was observed.