Acid-Base Balance of Cisternal and Lumbar Cerebrospinal Fluid in Hospital Patients

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Abstract
Simultaneous samples of cisternal and lumbar cerebrospinal fluid were obtained in 59 observations in 47 hospitalized patients, and the pH, carbon dioxide tension, and bicarbonate concentration were measured and compared with those in arterial blood. Eighteen patients also had simultaneous measurements of jugular venous blood. A consistent difference between the two cerebrospinal-fluid compartments was noted, with the pH lower (mean difference ± S.D., -0.039 ± 0.034) and the carbon dioxide tension higher (mean difference ± S.D., + 3.8 ± 5.2 mm Hg) in the lumbar region. Mean bicarbonate concentrations were equal in the two sites. The carbon dioxide tension of the cisternal fluid was about 1 mm Hg higher than the arithmetic mean of the arterial and jugular venous values.