Measurement of bicarbonate turnover in humans: applicability to estimation of energy expenditure

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Abstract
Bicarbonate turnover and energy expenditure were assessed in six healthy male volunteers, by the use of a constant infusion of radiolabeled bicarbonate (NaH14CO3) administered over 36 h, while the volunteers were confined to a whole body indirect calorimeter. Recovery and dilution of isotope were assessed from measurements made on continuous collections of CO2, entering and leaving the calorimeter, urine, and intermittent spot breath and saliva samples. Mean recovery of infused label in gaseous CO2 was 95.6 +/- 1.1% (SD) between 12 and 36 h. Applying a 95% mean recovery of label to each subject individually enabled the use of integrated mean specific activity of CO2 in spot breath and urine samples to predict measured net CO2 production and energy expenditure to within about +/- 6%. Estimates based on urinary measurements were compromised slightly by the exchange of label through the bladder wall (this was dependent on pH and volume of urine). It is concluded that this constant-infusion labeled bicarbonate method offers a potentially useful means of assessing net CO2 production and total energy expenditure over the short term (e.g., 1-3 days).