[Paradoxical reaction of intracellular pH values during therapy of acid-base imbalance with arginine hydrochloride].

A well known complication following surgical intervention is metabolic alkalosis. In general this acid-base disturbance is treated in our intensive care units by application of arginine-hydrochloride. In an experimental study on rats in vivo we determined the influence of this substance on the acid-base status of the extra- and intracellular body compartment. It was found that the extracellular bicarbonate decreases but there is nearly no influence on intracellular buffering. The "mean whole body pHi", an overall estimate of the intracellular pH as complementary to the in vivo determined extracellular plasma pH, was determined with DMO (5,5-dimethyl-2,4-oxazolidinedione) and shown to increase significantly after application of arginine-HCl. From this result it is concluded that arginine-hydrochloride should no longer be used for clinical therapy of metabolic alkalosis.