Cerebrospinal fluid and arterial lactate, pyruvate and acid-base balance in patients with intracranial hemorrhages

Stroke; a Journal of Cerebral Circulation
M FujishimaT Omae

Abstract

Lactate and pyruvate concentrations and acid-base balance in cerebrospinal fluid (CSF) and arterial blood were determined in patients with intracranial hemorrhages (28 subarachnoid hemorrhages and 15 intracerebral hemorrhages). A greater increase in CSF lactate and lactate-pyruvate ratio (L/P ratio) was observed in patients with impairment of consciousness, focal neurological deficits, poor prognosis, or CSF pressures higher than 300 mm H2O. A combination of CSF lactate greater than 2.5 mM per liter, L/P ration above 20, bicarbonate less than 20.4 mEq per liter, pH below 7.276, or arterial PCO2 below 31.5 mm Hg seems to indicate poor prognosis from intracranial hemorrhage. The mechanism of hyperventilation in acute cerebrovascular diseases and of CSF pH regulation in acid-base disturbances was also discussed.

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Citations

Mar 9, 2012·Translational Stroke Research·Fuyou GuoGuohua Xi
Mar 1, 1989·Journal of Neurology, Neurosurgery, and Psychiatry·H YaoM Fujishima
Jan 5, 2011·Critical Care : the Official Journal of the Critical Care Forum·Nguyen T HuyKenji Hirayama
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May 9, 2019·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Jonathan RothShlomi Constantini

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