Cerebrospinal Fluid Metabolic Acidosis and Brain Oxygen Supply

Abstract

During the first 12 days after suffering acute ischemic strokes, lumbar cerebrospinal fluid (CSF), arterial, and jugular venous blood samples of 102 patients were analyzed for acid-base and gas values. Significantly increased CSF lactate and pyruvate concentrations with correspondingly decreased bicarbonate ion levels were the most characteristic findings. Respiratory alkalosis and hypoxemia of arterial and cerebral venous blood were also common. Frequently, a supernormal jugular venous oxygen pressure was recorded. The majority of these patients had a more elevated CSF lactate concentration; the patients with pronounced cerebral venous hypoxemia had a smaller increase of CSF lactate level. Disturbances of brain acid-base status may be important in the regulation of cerebral blood flow and oxygen supply in patients with ischemic strokes.