Metabolic Acidosis Improves Airway Conductance in Patients with Asthma

The objective was to investigate whether acute metabolic acidosis could cause bronchodilation in patients with asthma. Twelve patients with asthma (8 females, mean age 39 (± SD 12) years, forced expiratory volume in 1 second [FEV1] 93 [±9] % predicted, PC20 1.9 (±1.0) mg/mL) participated in a double...

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Published in:The Journal of asthma Vol. 46; no. 7; pp. 656 - 658
Main Authors: Brijker, F., Van Den Elshout, F. J.J., Bosch, F. H., Heijdra, Y. F., Folgering, H. Th.M.
Format: Journal Article
Language:English
Published: England Informa UK Ltd 01.01.2009
Taylor & Francis
Subjects:
Acidosis - chemically induced
Administration, Oral
Adult
Airway Resistance - drug effects
Airway Resistance - physiology
Ammonium Chloride - administration & dosage
Ammonium Chloride - pharmacology
Ammonium Chloride - therapeutic use
asthma
Asthma - drug therapy
Asthma - physiopathology
Bronchial Hyperreactivity - drug therapy
Bronchial Hyperreactivity - physiopathology
bronchodilation
Double-Blind Method
Female
Forced Expiratory Volume - drug effects
Forced Expiratory Volume - physiology
Humans
Hydrogen-Ion Concentration - drug effects
In Vitro Techniques
Male
metabolic acidosis
Middle Aged
Peak Expiratory Flow Rate - drug effects
Peak Expiratory Flow Rate - physiology
specific airway conductance
Treatment Outcome
ISSN:0277-0903, 1532-4303, 1532-4303
Online Access:Get full text
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Summary:The objective was to investigate whether acute metabolic acidosis could cause bronchodilation in patients with asthma. Twelve patients with asthma (8 females, mean age 39 (± SD 12) years, forced expiratory volume in 1 second [FEV1] 93 [±9] % predicted, PC20 1.9 (±1.0) mg/mL) participated in a double-blind, placebo-controlled trial. Subjects ingested calculated amounts of ammonium chloride to induce acidosis or saline as placebo, in random order, each on a separate day. Airway resistance (Raw), specific airway conductance (sGaw), FEV1, and PEF were measured as primary variables. To evaluate the consequences of alterations in bronchial contractility on the airway responsiveness, the histamine provocation test (PC20) was measured as secondary variable. The intervention resulted in a mean (SD) decrease in base excess from -0.5 (±1.4) to -3.9 (±1.1) mmol/L (p < 0.01) and a decrease in pH from 7.41 (±0.02) to 7.36 (±0.02) (p < 0.01). This caused a statistically significant increase in sGaw from 1.15 (±0.16) to 1.26 (±0.13) 1/kPa.s) (p < 0.05). Tendencies towards increase were found in PEF (7.79 (±2.2) versus 8.09 (±1.9) (NS, p = 0.10) and in FEV1 (2.98 (±0.9) versus 3.06 (±0.9) (NS, p = 0.15). PC20 did not change significantly. It was concluded that acute metabolic acidosis has a modest bronchodilating effect in patients with asthma.
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SourceType-Scholarly Journals-1
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ISSN:0277-0903
1532-4303
1532-4303
DOI:10.1080/02770900902963110