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KMID : 0438219740110010597
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Korea University Medical Journal
1974 Volume.11 No. 1 p.597 ~ p.605
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Disturbances of Cerebral Acid-base balance and Gas metabolism in Craniocerebral Injury
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Abstract
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The main aim of the present work was planned to study the role of disturbances in brain gas exchange and disorders of cerebral acid-base balance on the development of brain damage and on the outcome of the diseased state in 36 patients with acute craniocerebral injuries who were admitted to Department of Neurosurgery, Korea University from March 1973 to August 1973 Cerebral acid-base balance and gas metabolism were measured by determining pH, PO?, and pCOz values in the cerebrospinal fluid (C. S. F. ) and venous blood by means of a Radiometer.
Oxygen saturation in the C. S. F. was calculated from the p0z-Oxygen saturation % nomogram, and standare bicarbonate and base excess in the venous blood were calculated from the Siggaard Anderson nomogram. In all groups test samples were obtained from the lumbar subarachnoid space and jugular vein.
In the investigation for the 36 patients with craniocerebral injury a considerable decreases of PCO2, and bicarbonate concentration of the C. S. F. were characteristic findings.
The results indicated that the development of the C. S. F. metabolic acidosis was the most common disorder in patients with craniocerebral injury. The most common findings in the venous blood was the considerably decreased pCOz and venous PON Hence the venous blood pH value was increased and the venous blood acid-base equilibrium was shifted toward the respiratory alkalosis.
The results of the biochemical measurments of C. S. F. in patients with clear consciousness did not differ substantially from the corresponding data obtained in the controls. The patient with disturbed consciousness showed, on the contrary, a remarkable C. S. F. metabolic acidosis which was most pronounced in a deep comatous state. The coma group had the lowest pOz of C. . F.. Venous p0z had a tendency to decrease in proportion to the severity of the state of consciousness. However, since the decrease in PCO2 was accompanied by a diminished bicarbonate concentration, only a modest increase in pH was noted.
There was more tendency to the metabolic acidosis in the C. S. F. pH of the fatal cases than that of the survivor cases.
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