Changes in sodium, potassium, and adenosine triphosphate contents of red blood cells in sepsis and septic shock.

Sepsis and septic shock were induced in fifteen awake rabbits by the infusion of live Escherichia coli. Sodium K+, and adenosine triphosphate (ATP) concentrations in red blood cells (RBC) and plasma were measured during the control, septic, and septic shock periods. The significant elevations of Na+ content in RBC during sepsis appeared to be primarily a function of increased cell membrane permeability. The significantly decreased intracellular K+ concentrations, accompanying the high Na+ levels of RBC later in shock, were consistent with progressive failure of the energy-dependent transport mechanism (Na+-k+ pump). Hyponatremia and hyperkalemia were apparent in the late stages of sepsis, these alterations reached statistically significant levels in the shock period. The electrolyte derangements associated with sepsis and septic shock could not be related to energy depletion. The continuous significant accumulations of ATP, observed in RBC and plasma, were interpreted as a result of decreased energy utilization and attributed to the diminished active ion transport by the impaired Na+-K+ pump.