Cerebrospinal Fluid and Arterial Lactate, Pyruvate and Acid-Base Balance in Patients With Intracranial Hemorrhages

Fujishima, Masatoshi; Sugi, Tomei; Choki, Jun-ichiro; Yamaguchi, Takenori; Omae, Teruo

doi:10.1161/01.str.6.6.707

Cited by 42 publications

(18 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…They include hypoxemia, 3 ' * hyperventilation, 5 -8 hypotensive shock, 7 circulatory arrest, 8 head injury, 9 and cerebrovascular diseases. 10 -" In our experience, 2 ' 12 an increase in CSF lactate and L/P ratio was significantly greater in stroke patients having disturbed consciousness or a poor prognosis than in those having normal consciousness or with a good recovery. L/P ratio of CSF reflects the redox state of the cytoplasmic NADH/NAD + system when CSF is in…”

Section: In 1967 Froman and Smithmentioning

confidence: 69%

Lactate and Pyruvate Concentrations, and Acid-Base Balance of Cerebrospinal Fluid in Experimentally Induced Intracerebral and Subarachnoid Hemorrhage in Dogs

Sugi

Fujishima

Omae

1975

Stroke

Self Cite

View full text Add to dashboard Cite

Abstract• The effect of blood injected into either subarachnoid space or subcortical brain tissue upon lactate and pyruvate concentrations as well as acid-base balance of cerebrospinal fluid (CSF) was studied in the anesthetized dog.CSF lactate and lactate/pyruvate ratio (L/P ratio) increased progressively following the intracranial injection of blood and reached the maximum level at six hours after injection. These changes were significantly greater in animals with intracerebral hematoma than in those with subarachnoid hemorrhage (SAH). An increase in CSF lactate and L/P ratio in hemorrhagic CSF seems to be caused by two different factors. Shed blood cells per se produce lactate and pyruvate, and blood in the subarachnoid space and intracerebral hematomas cause secondary changes in brain tissue metabolism by a probable reduction of cerebral blood flow. Therefore, an increase in CSF lactate with a concomitant rise in CSF L/P ratio is a useful indicator for brain tissue hypoxia, even when CSF is hemorrhagic.The association of an increase in CSF lactate to a disproportionate decrease in CSF HCO 3 was also observed in these animals. Additional Key Wordscerebral hypoxia lactate/pyruvate ratio anaerobic glycolysis

show abstract

Section: In 1967 Froman and Smithmentioning

confidence: 69%

Lactate and Pyruvate Concentrations, and Acid-Base Balance of Cerebrospinal Fluid in Experimentally Induced Intracerebral and Subarachnoid Hemorrhage in Dogs

Sugi

Fujishima

Omae

1975

Stroke

Self Cite

View full text Add to dashboard Cite

show abstract

“…Moreover, an increased CSF lactate level has been also proposed as a good indicator of CSF infection in intra-ventricular hemorrhagic patients with an external ventricular drain [60,61]. However, clinicians should be aware that CSF lactate is also increased in several central nervous system diseases such stroke (2 to 8 mmol/l) [62,63], convulsion (2 to 4 mmol/l) [64], cerebral trauma (2 to 9 mmol/l) [52], hypoglycemic coma (2 to 6 mmol/l) [65]. …”

Section: Discussionmentioning

confidence: 99%

Cerebrospinal fluid lactate concentration to distinguish bacterial from aseptic meningitis: a systemic review and meta-analysis

et al. 2010

View full text Add to dashboard Cite

IntroductionMaking a differential diagnosis between bacterial meningitis and aseptic meningitis is a critical clinical problem. The utility of a cerebrospinal fluid (CSF) lactate assay for this purpose has been debated and is not yet routinely clinically performed. To adequately evaluate this assay, a systematic review and meta-analysis of studies of the CSF lactate concentration as a marker for both bacterial meningitis and aseptic meningitis was performed.MethodsElectronic searches in PubMed, Scopus, the MEDION database and the Cochrane Library were conducted to identify relevant articles published before March 2009. A manual search of reference lists from selected articles was also conducted. Two reviewers independently selected relevant articles and extracted data on study characteristics, quality and accuracy.ResultsTwenty-five articles were identified that met the eligibility criteria. Diagnostic odds ratios were considerably homogenous (Chi-square P = 0.1009, I2 = 27.6%), and the homogeneity was further confirmed by a Galbraith plot and meta-regression analysis using several covariates. The symmetrical summary receiver-operator characteristic curve (SROC), fitted using the Moses-Shapiro-Littenberg method, was positioned near the upper left corner of the SROC curve. The Q value and area under the curve were 0.9451 and 0.9840, respectively, indicating excellent accuracy. The diagnostic accuracy of the CSF lactate concentration was higher than those of other four conventional markers (CSF glucose, CSF/plasma glucose quotient, CSF protein, and CSF total number of leukocytes) using a head to head meta-analysis of the 25 included studies.ConclusionsTo distinguish bacterial meningitis from aseptic meningitis, CSF lactate is a good single indicator and a better marker compared to other conventional markers.

show abstract

“…Immediately after sampling, 1.5 ml CSF or 4 ml ar terial blood was added to the same amount of 10% perchloric acid to remove protein, and the superna tant was stored in deep freezer until estimation. After neutralization with potassium hydroxide, lactate and pyruvate in CSF or blood were analyzed by standard enzymatic methods (Boehringer, Mannheim) [7,8,11 ]. Anaerobic samples of CSF and arterial blood were used for determination of Pco2, Po: and pH, using an IL Meter Model 113.…”

Section: Methodsmentioning

confidence: 99%

“…It has been reported that lactate levels in cerebrospinal fluid (CSF) are increased, and reflect well the severity of brain dysfunction in patients with hemorrhagic or occlusive cerebrovascular desease [7][8][9][10], malignant hypertension [11], meningitis and epileptic seizure [ 12], The purpose of this study was to examine whether glycolytic metabolism of the brain is impaired or not, and, if so, whether it might be correlated to neurologi cal symptoms in hepatic encephalopathy. We measured CSF lactate and pyruvate lev els in these patients before and/or after treat ment.…”

Section: Introductionmentioning

confidence: 99%

Cerebrospinal Fluid Lactate in Patients with Hepatic Encephalopathy

Yao¹,

Sadoshima²,

Fujii³

et al. 1987

Eur Neurol

Self Cite

View full text Add to dashboard Cite

Cerebrospinal fluid (CSF) lactate and pyruvate concentrations were determined in 16 patients with hepatic encephalopathy before and/or after treatment. CSF lactate was significantly increased to 1.92 ± 0.11 mmol/1 in hepatic encephalopathy before the treatment in comparison to 1.40 ± 0.05 mmol/1 in control subjects. In 9 of 11 patients with moderate or stage 2 encephalopathy, CSF lactate levels were below 2 mmol/1. In contrast, in 4 of 5 patients with stage 3–4 encephalopathy, CSF lactate levels were higher than 2 mmol/1. CSF lactate was decreased with the recovery of neurological symptoms by the treatment. These findings indicate that CSF lactate levels reflect the severity of metabolic impairment of the brain. Hypocapnia was frequently observed in these encephalopathic patients, and arterial Pco₂ correlated inversely with CSF lactate and linearly with CSF HCO^–₃, suggesting that CSF lactic acidosis contributes to hyperventilation in hepatic encephalopathy. It is concluded from present results that metabolic disorder of neuronal cells might be one of the important factors for the development of hepatic encephalopathy.

show abstract

Cerebrospinal Fluid and Arterial Lactate, Pyruvate and Acid-Base Balance in Patients With Intracranial Hemorrhages

Cited by 42 publications

References 34 publications

Lactate and Pyruvate Concentrations, and Acid-Base Balance of Cerebrospinal Fluid in Experimentally Induced Intracerebral and Subarachnoid Hemorrhage in Dogs

Lactate and Pyruvate Concentrations, and Acid-Base Balance of Cerebrospinal Fluid in Experimentally Induced Intracerebral and Subarachnoid Hemorrhage in Dogs

Cerebrospinal fluid lactate concentration to distinguish bacterial from aseptic meningitis: a systemic review and meta-analysis

Cerebrospinal Fluid Lactate in Patients with Hepatic Encephalopathy

Contact Info

Product

Resources

About