The effects of serum osmolarity on cerebrospinal fluid volume flow

Hochwald, G. M.; Wald, Abraham; DiMattio, Joseph; Malhan, C.

doi:10.1016/0024-3205(74)90312-9

Cited by 42 publications

(15 citation statements)

References 11 publications

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“…This variability may have been due in part to changes in the rate of CSF production. In cats, an increase in serum osmolarity caused by intravenous glucose infusion will lower the rate of CSF production (Hochwald et al, 1974).…”

Section: Resultsmentioning

confidence: 99%

Relationship between rat brain and cisternal CSF tryptophan concentrations.

Young¹,

Étienne²

1976

Journal of Neurology, Neurosurgery & Psychiatry

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SYNOPSIS Tryptophan was measured in the cisternal CSF and brains of rats. In untreated rats there was a significant but not very close correlation between the tryptophan concentration in these two compartments. Factors that change the brain tryptophan concentration such as starvation, glucose feeding, and lithium treatment affected the CSF tryptophan in the same way as the brain tryptophan. Diurnal changes were parallel for brain and CSF. When we take into account our knowledge of the disposition of tryptophan in human CSF, these data suggest that measurement of lumbar CSF tryptophan in man may be a useful approach to the study of human brain tryptophan. However, because the correlation between brain and CSF is not very close, measurements on CSF tryptophan would be more meaningful in groups of patients than in individuals.The turnover of biogenic amines in the central nervous system (CNS) of man has been investigated by measuring the metabolites of those amines in the lumbar cerebrospinal fluid (CSF). Experiments performed primarily on experimental animals but also with man have demonstrated that the concentration of the metabolites in lumbar CSF do reflect, to a certain extent, the turnover of the parent amine in the CNS (Moir et al., 1970;Garelis et al., 1974). Thus, 5-HIAA in the CSF bears a significant relation to the brain 5-hydroxytryptamine (5-HT) content.Recently, there has been increasing interest in the measurement of the biogenic amine precursor tryptophan in human CSF. Work on experimental animals has shown that tryptophan hydroxylase, the first enzyme on the pathway to 5-hydroxytryptamine, is not saturated with its substrate tryptophan under normal circumstances, and that changes in the brain tryptophan content will lead to changes in the rate of turn-1 This investigation received financial support from the Medical Research Council (Canada) and the Conseil de la Recherche en Sant6 du Qu6bec.

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Section: Resultsmentioning

confidence: 99%

Relationship between rat brain and cisternal CSF tryptophan concentrations.

Young¹,

Étienne²

1976

Journal of Neurology, Neurosurgery & Psychiatry

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“…Interestingly, even with a likely residual barbiturate blood level, we did not report any rebound in ICP after stopping the infusion. In the current algorithm, the slow tapering of continuous HSS treatment could have restored a normal brain osmolality without inducing a cerebral edema, as the dissipation of accumulated electrolytes and organic osmolytes takes place along with water repletion [6,28,32]. Finally, a slow reduction of the flow may be recommended in case of continuous HSS infusion.…”

Section: Discussionmentioning

confidence: 99%

“…HSS draws fluid from interstitial space, improves intracranial compliance, and decreases ICP, notably by counteracting the brain accumulation of extracellular osmolytes observed within blood-brain barrier dysfunction [6,7]. In this setting, a bolus of mannitol or of hypertonic saline solution (HSS) efficiently decrease the ICP [5,8].…”

Section: Introductionmentioning

confidence: 99%

Continuous controlled-infusion of hypertonic saline solution in traumatic brain-injured patients: a 9-year retrospective study

Roquilly¹,

Mahé²,

Latte³

et al. 2011

Critical Care

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IntroductionDescription of a continuous hypertonic saline solution (HSS) infusion using a dose-adaptation of natremia in traumatic brain injured (TBI) patients with refractory intracranial hypertension (ICH).MethodsWe performed a single-center retrospective study in a surgical intensive care unit of a tertiary hospital. Fifty consecutive TBI patients with refractory ICH treated with continuous HSS infusion adapted to a target of natremia. In brief, a physician set a target of natremia adapted to the evolution of intracranial pressure (ICP). Flow of NaCl 20% was a priori calculated according to natriuresis, and the current and target natremia that were assessed every 4 hours.ResultsThe HSS infusion was initiated for a duration of 7 (5 to 10) (8 ± 4) days. ICP decreased from 29 (26 to 34) (31 ± 9) mm Hg at H0 to 20 (15 to 26) (21 ± 8) mm Hg at H1 (P < 0.05). Cerebral perfusion pressure increased from 61 (50 to 70) (61 ± 13) mm Hg at H0 up to 67 (60 to 79) (69 ± 12) mm Hg at H1 (P < 0.05). No rebound of ICH was reported after stopping continuous HSS infusion. Natremia increased from 140 (138 to 143) (140 ± 4) at H0 up to 144 (141 to 148) (144 ± 4) mmol/L at H4 (P < 0.05). Plasma osmolarity increased from 275 (268 to 281) (279 ± 17) mmol/L at H0 up to 290 (284 to 307) (297 ± 17) mmol/L at H24 (P < 0.05). The main side effect observed was an increase in chloremia from 111 (107 to 119) (113 ± 8) mmol/L at H0 up to 121 (117 to 124) (121 ± 6) mmol/L at H24 (P < 0.05). Neither acute kidney injury nor pontine myelinolysis was recorded.ConclusionsContinuous HSS infusion adapted to close biologic monitoring enables long-lasting control of natremia in TBI patients along with a decreased ICP without any rebound on infusion discontinuation.

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“…All perfusions were at a pressure of 0-5 cm Hz 0 with respect to the interaural line, so as to assure mixing of ventricular fluid. The perfusion fluid used was a simulated CSF having an ionic composition similar to the natural fluid (Hochwald et al, 1974). Effluent flow rate was determined gravimetrically by collection in tared tubes over 15-minute intervals.…”

Section: Methodsmentioning

confidence: 99%

Sodium exchange between blood, brain, and CSF in normal and hydrocephalic cats

Hochwald¹,

Wald²,

Marlin³

et al. 1977

J of Neuroscience Research

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The exchange of sodium between blood, brain, and cerebrospinal fluid was studied in normal and kaolin-induced hydrocephalic cats. The ventricles were perfused to measure fluid formation and Na+ exchange rates. 22Na was added to the perfusion fluid or injected intravenously as a tracer for Na+ movement. Na+ and 22Na were also measured in cortical gray and white matter. Na+ relative specific activities were calculated for brain, effluent fluid, and serum. With 22Na in the perfusion fluid, Na+ exchange was not different from nascent Na+ influx for both normal and hydrocephalic cats. Na+ relative specific activities of cortical gray and white matter were 10 times greater in hydrocephalic than in normal cats. This difference in Na+ relative specific activity for brain may be due to a higher diffusion constant or to a lower brain capillary permeability. When 22Na was given intravenously, the Na+ diffusional exchange for normal cats was less than that measured when 22Na+ was in the perfusion fluid. In hydrocephalic cats, the Na+ diffusional exchange was effectively zero. Na+ relative specific activities of cortical gray and white matter were the same for normal and hydrocephalic cats. These findings suggest that the impaired Na+ diffusional exchange may be due to pathological changes in the choroid plexus.

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The effects of serum osmolarity on cerebrospinal fluid volume flow

Cited by 42 publications

References 11 publications

Relationship between rat brain and cisternal CSF tryptophan concentrations.

Relationship between rat brain and cisternal CSF tryptophan concentrations.

Continuous controlled-infusion of hypertonic saline solution in traumatic brain-injured patients: a 9-year retrospective study

Sodium exchange between blood, brain, and CSF in normal and hydrocephalic cats

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