Cerebrospinal Fluid (CSF) Lactate and Pyruvate in Acute Neurological Situations

Berger, Jean-Pierre; Fawer, R.

doi:10.1159/000402819

Cited by 8 publications

(4 citation statements)

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“…Despite some overlap in concentrations between Groups I-VI (Figure 3), the CSF lactate test was superior to the other CSF tests for the diagnosis of acute bacterial meningitis, if a discriminatory level of 3.5 mmol/1 was chosen ( (25,27,37), studies using CSF specimens collected from a variety of patients, regardless of the actual disease prevalence (26,29), may lead to false conclusions about the clinical usefulness of the CSF lactate test.…”

Section: Discussionmentioning

confidence: 99%

Value of cerebrospinal fluid analysis in the differential diagnosis of meningitis: A study in 710 patients with suspected central nervous system infection

Lindquist

Linné

Hansson

et al. 1988

Eur. J. Clin. Microbiol. Infect. Dis.

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A prospective study to determine the value of cerebrospinal fluid analysis in the differential diagnosis of meningitis was performed in 710 consecutively observed patients, both children and adults, who underwent lumbar puncture due to suspected central nervous system infection. Diagnoses included acute or presumed bacterial meningitis (n = 79), acute or presumed viral meningoencephalitis (n = 218), acute unclassified meningitis (n = 6), other infections of the central nervous system (n = 37), non-infectious neurological diseases (n = 76) and control patients (n = 294). The sensitivity, specificity and predictive values were determined for cerebrospinal fluid white blood cell count, total protein, lactate, glucose and C-reactive protein levels as well as the blood/cerebrospinal fluid glucose ratio. Determination of cerebrospinal fluid levels of lactate (greater than or equal to 3.5 mmol/l) was found to be superior to the other tests. The C-reactive protein level gave no additional diagnostic information when the lactate level was determined. The white blood cell count, and total protein and glucose levels were often unreliable tools for differential diagnosis, largely due to low sensitivity at realistic discriminatory limits. The study confirms that no cerebrospinal fluid test is fully reliable in distinguishing bacterial meningitis from other forms of meningitis.

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Section: Discussionmentioning

confidence: 99%

Value of cerebrospinal fluid analysis in the differential diagnosis of meningitis: A study in 710 patients with suspected central nervous system infection

Lindquist

Linné

Hansson

et al. 1988

Eur. J. Clin. Microbiol. Infect. Dis.

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“…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

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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.

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“…Bei bakteriellen Meningitiden liefert die einmalige Bestimmung der Laktatkonzentration bei der Diagnosestellung keinen Anhalt über die Prognose der Erkrankung (5,14,20). Die zusätzliche Bestimmung der Pyruvatkonzentration oder die Berechnung des Laktat/Pyruvat-Quotienten bzw.…”

Section: Prognostische Bedeutung Der Laktatkonzentration Im Liquorunclassified

Übersichtsreferate

1983

LaboratoriumsMedizin

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In cerebrospinal fluid, the concentration oflactate is elevated above the upper limit of the normal range (> 2.0mmol/l) in a great variety of inflammatory, vascular, neoplastic, and metabolic diseases of the brain and the meninges, respectively. The determination oflactate can help to differentiate 1. untreated or partially treated bacterial meningitis from viral meningitis. 2. transient ischemic attacks from generalized epileptic seizures when anamnestic or clinical information is not available and 3. artificial bloody contamination of the CSF due to lumbar puncture from true intracerebral or subarachnoidal hemorrhage. Repeated evaluations of the lactate concentration allow to control the effectiveness of therapy. In vascular and traumatic brain disease and in intoxications as well the lactate concentration has prognostic significance.

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Cerebrospinal Fluid (CSF) Lactate and Pyruvate in Acute Neurological Situations

Cited by 8 publications

References 0 publications

Value of cerebrospinal fluid analysis in the differential diagnosis of meningitis: A study in 710 patients with suspected central nervous system infection

Value of cerebrospinal fluid analysis in the differential diagnosis of meningitis: A study in 710 patients with suspected central nervous system infection

Cerebrospinal Fluid Lactate in Patients with Hepatic Encephalopathy

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