The significance of determination of na⁺, k⁺ in red blood cells in diagnosis and management of digitalis intoxication

Summary

Intraerythrocytic K⁺ and Na⁺ were determined to study their significance in diagnosing and treating digitalis intoxication.

77 patients studied were divided into 4 groups: (1) 14 in toxic group; (2) 13 in digoxin treatment group; (3) 20 in combined group; and (4) 30 normal persons as controls.

The values of [Na⁺]_i and [Na⁺]_i/[K⁺]_i were much higher in toxic group than in nontoxic group. [Na⁺]_i was 16.91 in toxic group and 12.64 in nontoxic group, whereas [Na⁺]_i/[K⁺]_i 0.209 in toxic group, and 0.147 in nontoxic group (P < 0.01). They dropped remarkably 1 week after discontinuance of digitalis. [Na⁺]_i dropped to 10.05, and the ratio of [Na⁺]_i/[K⁺]_i to 0.113. The same alterations appeared in combined and digoxin treatment group, as distinct from controls.

The mechanism of toxic response of digitalis pertaining to intraerythrocytic electrolytes was discussed, and the guiding parameter in treating digitalis intoxication was also suggested.

The dynamic observation of [Na⁺+]_i, [K⁺]_i; and [Na⁺ _i/[K⁺]_i for diagnosis and treatment of digitalis intoxication were advised.