The Effects of Sodium Bicarbonate on Cerebrospinal Fluid Acid-Base Disturbances in Total Cerebral Ischemia

  • Akitsugu Kohama
  • Nobukatsu Takasu
  • Shinichi Ishimatsu
  • Akiyuki Maenosono
  • Kouichiro Suzuki


If normal circulation or ventilation is stopped, a living body progressively falls into hypoxemia; continuation of this condition will worsen tissue and organ damage. In order to ameliorate this condition, cardiopulmonary cerebral resuscitation (CPCR) is usually performed. In CPCR, cerebral resuscitation is critical because of the difficulty in accomplishing it and because, if it does not succeed, the human being ceases to exist as a human being.


Control Level Metabolic Acidosis Sodium Bicarbonate Normal Circulation Catheter Method 
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  1. 1.
    Siesjö BK, Kjällzuist A, Zwetnow N (1968) The CSF lactate/pyruvate ratio in cerebral hypoxia. Life Sci 7: 45–52PubMedCrossRefGoogle Scholar
  2. 2.
    Metzel E, Zimmermann WE (1971) Changes of oxygen pressure, acid-base balance, metabolites and electrolytes in cerebrospinal fluid and blood after cerebral injury. Acta Neurochi (wien) 25: 177–188CrossRefGoogle Scholar
  3. 3.
    Tabuse H, Fukuda A (1981) Cerebral pathophysiological changes after cardiopulmonary resuscitation (in Japanese). Jpn J Acute Med 5: 317–323Google Scholar
  4. 4.
    Kohama A, Nakamura Y, Nakamura M, Yano M, Shibatani K (1984) Continuous monitoring of arterial and tissue PCO2 Crit Care Med 12: 940–942PubMedCrossRefGoogle Scholar
  5. 5.
    Mitchell RA, Herbert DA, Carman CT (1965) Acid-base constants and temperature coefficients for cerebrospinal fluid. J Appl Physiol 20: 27–30PubMedGoogle Scholar
  6. 6.
    Bering EA, Sato O (1963) Hydrocephalus: Changes in formation and absorption of cerebrospinal fluid within the cerebral ventricles. J Neurosurg 20: 1050–1055PubMedCrossRefGoogle Scholar
  7. 7.
    Valenca LM, Shannon DC, Kazemi H (1971) Clearance of lactate from the cerebrospinal fluid. Neurology 21: 615–620PubMedGoogle Scholar
  8. 8.
    Kazemi H, Johnson DC (1986) Regulation of cerebrospinal fluid acid-base balance. Physiol Rev 66: 953–1037PubMedGoogle Scholar
  9. 9.
    Mima T, Takakura K (1987) Cerebrospinal fluid circulation and electrolytes transport (in Japanese). Jpn J Clin Med 45: 263–272Google Scholar
  10. 10.
    Posner JB, Plum F (1967) Independence of blood and cerebrospinal fluid lactate. Arch Neurol 16: 492–496PubMedCrossRefGoogle Scholar
  11. 11.
    Jaraheri S, Clendening A, Papadakis N, Brody JS (1984) pH Changes on the surface of brain and in cisternel fluid in dogs in cardiac arrest. Stroke 15: 553–557Google Scholar
  12. 12.
    Posner JB, Swanson AG, Plum F (1965) Acid-base balance in cerebrospinal fluid. Arch Neurol 12: 479–496PubMedCrossRefGoogle Scholar
  13. 13.
    Posner JB, Plum F (1967) Spinal fluid pH and neurologic symptoms in systemic acidosis. N Engl J Med 277: 605–613PubMedCrossRefGoogle Scholar
  14. 14.
    Ohman JL, Kozak GP (1971) The cerebrospinal fluid in diabetic ketoacidosis. New Engl J Med 284: 283–290PubMedCrossRefGoogle Scholar
  15. 15.
    Siesjö BK (1984) Administration of base via the CSF route: A clinically useful treatment of cerebral acidosis? Intensive Crit Care Digest 3: 5–9Google Scholar
  16. 16.
    Stewart JSS (1964) Management of cardiac arrest, with special reference to metabolic acidosis. Br Med J 1: 476–479PubMedCrossRefGoogle Scholar
  17. 17.
    Minuck M, Sharma GP (1977) Comparison of THAM and sodium bicarbonate in resuscitation of the heart after ventricular fibrillation in dogs. Anesth Analg 56: 38–45PubMedCrossRefGoogle Scholar
  18. 18.
    Graff HW, Leach W, Arieff Al (1985) Evidence for a detrimental effect of bicarbonate therapy in hypoxic lactic acidosis. Science 227: 754–757CrossRefGoogle Scholar
  19. 19.
    Berenyi KJ, Wolk M, Killip T (1975) Cerebrospinal fluid acidosis complicating therapy of experimental cardiopulmonary arrest. Circulation 52: 319–324PubMedGoogle Scholar
  20. 20.
    Bishop RL, Weisfeldt ML (1976) Sodium bicarbonate administration during cardiac arrest, effect on arterial pH, PCO2 and osmolality. JAMA 235: 506–509PubMedCrossRefGoogle Scholar
  21. 21.
    Niemann JT, Rosborough JP (1984) Effects of acidemia and sodium bicarbonate therapy in advanced cardiac life support. Ann Emerg Med 13: 781–784PubMedCrossRefGoogle Scholar
  22. 22.
    Lawson NW, Butler GH III, Roy CT (1973) Alkalosis and cardiac arrythmia. Anesth Analg 52: 951–965PubMedCrossRefGoogle Scholar
  23. 23.
    Bellingham AJ, Detter JC, Lenfant C (1971) Regulatory mechanisms of hemoglobin-oxygen affinity in acidosis and alkalosis. J Clin Invest 50: 700–706PubMedCrossRefGoogle Scholar
  24. 24.
    Relman AS (1972) Metabolic consequences of acid-base disorders. Kidney Int 1: 347–358PubMedCrossRefGoogle Scholar
  25. 25.
    Weil MH, Rackow EC, Trevino R, Grundler W, Falk JL, Griffel Ml (1986) Difference in acid-base state between venous and arterial blood during cardio-pulmonary resuscitation. N Engl J Med 315: 153–156PubMedCrossRefGoogle Scholar
  26. 26.
    Sessler D, Mills P, Gregory G, Litt L, James T (1987) Effects of bicarbonate on arterial and brain intracellular pH in neonatal rabbits recovering from hypoxic lactic acidosis. J Pediatr 111: 817–823PubMedCrossRefGoogle Scholar
  27. 27.
    Wiklund LW, Soderberg D, Henneberg S, Rubertsson S, Stjernström H, Groth T (1986) Kinetics of carbon dioxide during cardiopulmonary resuscitation. Crit Care Med 8: 1015–1022CrossRefGoogle Scholar
  28. 28.
    Filley GF, Kindig NB (1984) Carbicarb, an alkalinizing ion-generating agent of possible clinical usefulness. Trans Am Clin Climatol Assoc 96: 141Google Scholar
  29. 29.
    Bersin RM, Arieff AL (1988) Improved hemodynamic function during hypoxia with Carbicarb, a new agent for the management of acidosis. Circulation 77: 227–233PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Tokyo 1991

Authors and Affiliations

  • Akitsugu Kohama
  • Nobukatsu Takasu
  • Shinichi Ishimatsu
  • Akiyuki Maenosono
  • Kouichiro Suzuki
    • 1
  1. 1.Department of Emergency and Critical Care MedicineKawasaki Medical SchoolKurashikiJapan

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