Effects of Lactic Acid Infusions and pH on Cerebral Blood Flow and Metabolism

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Abstract
To determine the effects of lactic acidemia versus lactate on CBF, we infused lactic acid, either buffered with NaOH (L + NaOH) or with added NaCl (L + NaCl), to attain similar osmolalities in 18 piglets. CBF (microsphere technique), pH, blood gases, plasma osmolality, and cerebral arteriovenous differences of O2 content and lactic acid concentrations were measured prior to, at 30 min of a lactic acid infusion, and 15 and 90 min after completion of the infusion. Control arterial pH was comparable between groups (7.50 ± 0.02 vs. 7.49 ± 0.02, X̄ ± SE); during and following L + NaCl and L + NaOH, values were (p < 0.05) 7.09 ± 0.03, 7.35 ± 0.02, and 7.46 ± 0.02 vs. 7.58 ± 0.03,7.61 ± 0.01, and 7.57 ± 0.03, respectively. PaCO2 remained unchanged and osmolality rose by 15% in both groups during infusions and persisted throughout the study period. For L + NaCl piglets, CBF (ml/min · 100 g) rose from 136 ± 15 to 198 ±26 (p < 0.05) at 30 min of infusion and remained elevated at 201 ± 25 and 207 ± 28 at 15 and 90 min following the infusion, respectively. Similarly, for L + NaOH piglets, CBF rose from 130 ± 25 to 196 ±31 (p < 0.05) with the infusion and was 174 ± 17 and 166 ± 21 at 15 and 90 min afterward, respectively. Although lactic acid infusion increases CBF, the associated metabolic acidemia is not responsible for changes in CBF.