Lactic acid of normal and pathological spinal fluids.

Abstract

2556-8 weeks from the onset of the attack, the T wave may lose its characteristic shape and approach the normal. From our experience in other cases of coronary artery occlusion, we know that the cove-plane T may persist for years. On the other hand, we have seen no example of long duration of the changes of the first stage, i. e., marked elevation of the R-T transition. The general similarity of the successive changes in the four cases cannot be regarded as accidental. Therefore, it iiiay be said that the early electrocardiographic changes associated with acute coronary artery occlusion are first seen in the R-T interval, and then in the T wave itself. 2920Lactic acid of normal and pathological spinal fiuids.In 1917 Levinson' observed that spinal fluids from cases of epidemic meningitis immediately after withdrawal had a subnormal pH. This was in some instances further decreased when the fluids were permitted to stand a t room temperature unstoppered. However, normal and tuberculous meningitic fluids when freshly drawn showed similar figures for pH, and the pH increased on standing, particularly in the tuberculous fluids. Levinson believed that the lowering of the p H of the spinal fluid in meningococcus meningitis was due to the accumulation of lactic acid in the fluid, but he presented no data to substantiate this explanation.In the present communication, data are presented for the sugar and lactic acid of the spinal fluid of normals, miscellaneous pathological conditions and meningitis. Clausen's method was employed for the determination of the lactic acid, and the Folin-Wu procedure for the sugar.Specimens of spinal fluid obtained from five normal adults, after a night's fast and rest, showed lactic acid concentration from 8 to 15 mg. per 100 cc. In twenty-one miscellaneous non-meninllevinson, A,, J . Infect. D k , 1917, xxi, 556.

Gas liquid chromatography in the rapid diagnosis of meningitis.

“…This finding was confirmed by Nishimura (1924) and Killian (1925), and more recent reports (Montani and Perret, 1964;Sudre and Reiss, 1969;Lamisse et al, 1972;Bland et al, 1974;Controni et al, 1975) have demonstrated the value of estimating the concentration of lactic acid in CSF for distinguishing between viral and bacterial meningitis. The present study was undertaken to evaluate gas liquid chromatography for measuring CSF lactic acid as an adjunct to routine tests in the diagnosis and treatment of pyogenic meningitis.…”

Dosage of lactate in the cerebrospinal fluid in infectious diseases of the central nervous system

“…Menninger, in 1924, found elevated values of lactate (LA) in CSF from patients with bacterial meningitis 7 . Posner and Plum (1967) confirm the independence of LA in blood and in CSF and conclude that the LA in CSF is a good indicator of the cerebral metabolism 7,8 . The LA is a product of the metabolism of the carbohydrates by anaerobic via.…”

Cerebrospinal fluid lactate in post-neurosurgical bacterial meningitis diagnosis

“…To the best of our knowledge, this is the largest prospective study on the use of CSF lactate to discriminate between PNBM and other inflammatory CSF conditions. CSF acidosis due to bacterial infection has been known for a long time [12][13][14], and CSF lactate has been available circa 1920. However, despite its use in the pediatric population to differentiate between bacterial and viral meningitis [11,20], the use of CSF lactate in the adult population has been limited because of the availability of the test and questions that arose regarding its utility [2].…”

“…Lactate slowly crosses the blood-brain barrier and has decreased CSF clearance, consequently representing a useful indicator of brain metabolism [17]. CSF lactate is used to distinguish bacterial from viral meningitis in children (discriminatory threshold between 3.5 and 4 mmol/L [11][12][13][14][15][16][17][18][19]), as well as to discriminate between types of inflammatory response, demonstrating good correlation with infection in several retrospective series [7][8][9][10]. In a retrospective study, Leib et al [2] have evaluated glucose CSF:blood ratio and CSF lactate levels in neurosurgical patients for proven or probable PNBM vs. no meningitis diagnosis.…”

“…CSF lactic acid has been proposed as a potential marker distinguishing between infection and inflammation [11]. When CSF infection is present, leukocytes increase anaerobic glucose metabolism, thus producing lactic acid and lowering pH [11][12][13][14][15]. Bacterial metabolism, neutrophil glycolysis and anaerobic metabolism of brain tissue during bacterial meningitis lead to CSF lactate accumulation [16].…”