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ID 17955
Eprint ID
17955
フルテキストURL
Thumnail 82_361.pdf 819 KB
タイトル(別表記)
Studies on acid base balance of the cerebrospinal fluid under acute intracranial hypertension
著者
土井 章弘 岡山大学医学部脳神経外科学教室
抄録
The author devised on pparatus for continuous monitoring of acid base balance of CSF without any CSF exposure to the atomosphere. The apparatus is an extracorporeal "ventriculo-cisternal circulation system" which is consisted of pressure pump, glass capillary electrode, Clark PO(2) eleotrode and Severinghaus Pco(2) electrode, all-lined up on a stainless steal conduit betweeen lateral ventricle and cisterna magna. In the experimental cases of 5 dogs, the ventriculo-cisternal circulation system was used for monitoring acid base balanec of the CSF under acute intracranial hypertension produced by extradural balloon inflation. The blood Pco(2) was constantly watched during experiment to be kept in the normal range by means of a respirator. Pco(2) in the CSF began to increase in early stage above the pressure of CSF of 300 mmH(2)O and incseased more and more in parallel with raised pressure. HCO(3)- in the CSF was decreased when acute and more severe intracranial hypertension was maintained for hours. Hypercapnic acidosis and metabolic acidosis occured in the CSF specifically when the intracranial pressure was raised acutely. Clinically, acid base balance of the CSF was studied on acute intracranial hypertension of three patients who suffered from brain tumor. Intracranial pressure was monitored continuously by pressure gauge transducer connected to the ventricular drainage. In this clinical research, CSF, arterial blood and jugular blood were sampled for measurement. Pco(2) in the CSF was increased when the intracranial pressure was elevated above 500mmH(2)O and metabolic acidosis was added when the pressure was more elevated continued. That is to say, CSF became acidosis as same as experimental results. On the contrary, arterial blood became respiratory alkalosis when the intracranial pressure was elevated to 500-1000mmH(2)O. This phenomenon suggest that increse of hydrogenic ions induced by intracranial hypertension stimulates respiratory center. Hypercapnic acidosis and metabolic acidosis occur specifically in the CSF independently from the change in the blood when the intracranial pressure rises. Namely, the acid base balance of the CSF can not evaluated from that of the blood. The author adovocates this state is hidden acidosis.
発行日
1970-08-31
出版物タイトル
岡山医学会雑誌
出版物タイトル(別表記)
Journal of Okayama Medical Association
82巻
7-8号
出版者
岡山医学会
出版者(別表記)
Okayama Medical Association
開始ページ
361
終了ページ
372
ISSN
0030-1558
NCID
AN00032489
資料タイプ
学術雑誌論文
オフィシャル URL
https://www.jstage.jst.go.jp/article/joma1947/82/7-8/82_7-8_361/_article/-char/ja/
関連URL
http://www.okayama-u.ac.jp/user/oma/
言語
Japanese
著作権者
岡山医学会
論文のバージョン
publisher
査読
有り
Eprints Journal Name
joma