REFERENCE VALUES OF NORMAL CEREBROSPINAL FLUID COMPOSITION IN INFANTS AGES 0 TO 8 WEEKS

Abstract Background: Analysis of cerebrospinal fluid (CSF) parameters helps clinicians identify patients with central nervous system (CNS) disease. In previous literature, reference values for CSF may be based on patients who were not truly healthy, other species, or outdated information. In the present study, we performed lumbar puncture in patients requiring spinal anesthesia by a reasonable indication to evaluate CSF parameters in healthy adults. Methods: All patients between the ages of 20 and 70 years scheduled for elective orthopedic or urologic surgery requiring spinal anesthesia were enrolled in this study. We measured electrolytes and gas tension analysis in CSF and whole blood samples in adult humans. Results: A total of 28 patients were included with an average age of 44.2 years. The pH of blood and CSF were both neutral, but it was slightly lower in blood. The concentration of Na+ in blood was slightly lower compared with that in CSF. There were significantly higher levels of K+ and Ca2+ in the blood compared with CSF. Significantly lower levels of Cl- and Mg2+ in the blood were observed compared with CSF. The glucose level of CSF was about half of that in blood. Conclusions: We provided updated reference values for various solutes in blood and CSF in adults. Although normal CSF constituents are quite similar to that of blood, there is still a small difference in normal values between them. Analysis of CSF parameters and relevant paired blood samples is highly informative, helping clinicians diagnose a variety of CNS diseases. Trial registration: This present study was approved by the Institutional Review Board of Chang Gung Medical Foundation, Taiwan (approval number: 201600122A3), and is registered under Clinical Trials Registry (ClinicalTrials.gov Identifier: NCT03725709).

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Updated cerebrospinal fluid total protein reference values improve chronic inflammatory demyelinating polyneuropathy diagnosis

Muscle & Nerve ◽

10.1002/mus.26488 ◽

2019 ◽

Vol 60 (2) ◽

pp. 180-183 ◽

Cited By ~ 12

Author(s):

Ari Breiner ◽

Pierre R. Bourque ◽

Jeffrey A. Allen

Keyword(s):

Cerebrospinal Fluid ◽

Reference Values ◽

Total Protein ◽

Chronic Inflammatory Demyelinating Polyneuropathy ◽

Demyelinating Polyneuropathy ◽

Inflammatory Demyelinating Polyneuropathy

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Cerebrospinal Fluid Protein Concentrations in Children: Age-related Values in Patients without Disorders of the Central Nervous System

Clinical Chemistry ◽

10.1093/clinchem/46.3.399 ◽

2000 ◽

Vol 46 (3) ◽

pp. 399-403 ◽

Cited By ~ 23

Author(s):

Daniel Biou ◽

Jean-François Benoist ◽

Claire Nguyen-Thi ◽

Xuan Huong ◽

Philippe Morel ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Reference Values ◽

Total Protein ◽

Age Groups ◽

Term Neonates ◽

Age Related ◽

The Central Nervous System ◽

Set Up ◽

Age Range ◽

Cerebrospinal Fluid Protein

Abstract Background: The published reference values for cerebrospinal fluid (CSF) total protein concentrations in children suffer from two major drawbacks: (a) the age-related range often is too broad when applied to the steeply falling concentrations in early infancy; and (b) no values have been published for widely used dry chemistry methods. Methods: We conducted a 2-year retrospective survey of CSF results obtained in a children’s hospital with a dry chemistry-based method set up on the Vitros 700 analyzer. Results: The data related to ambulatory children up to 16 years of age and term neonates with no clinical or biological signs of brain disease (n = 1074). Seven age groups with significantly different CSF protein values were identified, and their age-related percentiles (5th, 50th, and 95th) were determined. On the basis of the upper 95th percentile, from age 0 to 6 months the CSF protein concentrations fell rapidly from 1.08 to 0.40 g/L. A plateau (0.32 g/L) was reached from age 6 months to 10 years, followed by a slight increase (0.41 g/L) in the 10–16 years age range. Conclusions: These results imply that CSF total protein concentrations in the pediatric setting, particularly in infants, must always be interpreted with regard to narrow age-related reference values to avoid false-positive results.

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Automated Kinetic Spectrophotometric Assays of Enzyme Activities of Human Cerebrospinal Fluid: Methods and Reference Values

Clinical Chemistry ◽

10.1093/clinchem/19.2.240 ◽

1973 ◽

Vol 19 (2) ◽

pp. 240-247 ◽

Cited By ~ 6

Author(s):

David M Sharpe ◽

A Ross Wilcock ◽

David M Goldberg

Keyword(s):

Cerebrospinal Fluid ◽

Lactate Dehydrogenase ◽

Malate Dehydrogenase ◽

Reference Values ◽

Major Effect ◽

Aspartate Transaminase ◽

Exogenous Enzyme ◽

Human Cerebrospinal Fluid ◽

Upper Limits ◽

Kinetic Spectrophotometric

Abstract Optimum conditions with respect to pH and molarity of phosphate buffer, and the concentrations of substrates, coenzymes, and exogenous enzyme, were defined at 37°C for activity of aspartate transaminase and lactate dehydrogenase of human cerebrospinal fluid (CSF), as measured by optical kinetic assays at 340 nm. The resulting methods, and a previously published procedure for malate dehydrogenase activity applicable to human CSF, were adapted for use with an automatic reaction-rate monitor. Within-batch and between-batch precision of all methods was satisfactory, and repeated estimations in seven subjects showed good agreement. Freezing samples decreased their activity by 5 to 10%, but thereafter no further losses occurred at -20°C for as long as three months. Injection of up to 12 ml of air during encephalography had no major effect. Reference values, derived from subjects with no neurological or simple chronic degenerative CNS disease, suggested that the upper limits (in U/liter) are: aspartate transaminase, 13.5; lactate dehydrogenase, 40; malate dehydrogenase, 58.

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1486 Full-term gestation and premature neonates: Cerebrospinal fluid (CSF) reference values

Journal of the Neurological Sciences ◽

10.1016/s0022-510x(05)81846-5 ◽

2005 ◽

Vol 238 ◽

pp. S478-S479

Keyword(s):

Cerebrospinal Fluid ◽

Reference Values ◽

Full Term ◽

Premature Neonates

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The effect of chronic and acute changes in plasma composition on vasopressin secretion and cerebrospinal fluid in the rat

Acta Endocrinologica ◽

10.1530/acta.0.1270174 ◽

1992 ◽

Vol 127 (2) ◽

pp. 174-178 ◽

Cited By ~ 2

Author(s):

Timothy Wells ◽

Richard J Balment

Keyword(s):

Cerebrospinal Fluid ◽

New Zealand ◽

Plasma Osmolality ◽

Sodium Concentration ◽

Fluid Composition ◽

Plasma Composition ◽

Plasma Vasopressin ◽

Vasopressin Secretion ◽

Acute Changes ◽

Hypertonic Saline Injection

The effects of chronic and acute changes in plasma composition on the osmolality and sodium concentration of cerebrospinal fluid and plasma vasopressin (AVP) concentration have been examined. Chronic elevation of plasma osmolality in three strains of genetically AVP-deflcient rats (Brattleboro and New Zealand hypertensive and normotensive Brattleboro) was associated with increased cerebrospinal fluid osmolality by comparison with AVP-replete controls (Long Evans and New Zealand genetically hypertensive and normotensive rats). The linear correlation between plasma and cerebrospinal fluid osmolality did not reflect a similar relationship between plasma and cerebrospinal fluid sodium concentration. Hypertensive animals exhibited a threefold higher plasma AVP concentration in association with significantly elevated cerebrospinal fluid osmolality by comparison with normotensive controls. Although ip hypertonic saline injection elicited parallel increases in plasma and cerebrospinal fluid osmolality and sodium concentration in both hypertensive and normotensive rats, only in the normotensives did this result in an increase in plasma AVP concentration. These results indicate that cerebrospinal fluid is subject to modest chronic and acute changes in osmolality and sodium concentration which may contribute to the osmotic control of AVP secretion. The disturbed control of vasopressin secretion in hypertensive rats may in part be related to the abnormal cerebrospinal fluid composition in these animals.

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Reference Values For Intracranial Pressure And Lumbar Cerebrospinal Fluid Pressure: A Systematic Review

10.21203/rs.3.rs-143580/v1 ◽

2021 ◽

Author(s):

Nicolas Hernandez Norager ◽

Markus Harboe Olsen ◽

Sarah Hornshoej Pedersen ◽

Casper Schwartz Riedel ◽

Marek Czosnyka ◽

...

Keyword(s):

Systematic Review ◽

Cerebrospinal Fluid ◽

Intracranial Pressure ◽

Reference Values ◽

Supine Position ◽

Body Position ◽

Fluid Pressure ◽

Reference Intervals ◽

Cerebrospinal Fluid Pressure ◽

Lumbar Cerebrospinal Fluid

Abstract BackgroundAlthough widely used in the evaluation of the diseased, normal intracranial pressure and lumbar cerebrospinal fluid pressure remains sparsely documented. Intracranial pressure is different from lumbar cerebrospinal fluid pressure. In addition, intracranial pressure differs considerably according to body position of the patient. Despite this, the current reference interval are used indistinguishable for intracranial and lumbar cerebrospinal fluid pressure, and body position dependent reference intervals does not exist. In this study, we aim to establish these reference intervals.MethodA systematic search was conducted in MEDLINE, EMBASE, CENTRAL, and Web of Sciences. Methodological quality was assessed using an amended version of the Joanna Briggs Quality Appraisal Checklist. Intracranial pressure and lumbar cerebrospinal fluid pressure were independently evaluated and subdivided into body positions. Quantitative data were presented with mean ± SD, and 90% reference intervals.ResultsThirty-six studies were included. Nine studies reported values for intracranial pressure, while 27 reported values for the lumbar cerebrospinal fluid pressure. Reference values for intracranial pressure were -5.9 to 8.3 mmHg in the upright position and 0.9 to 16.3 mmHg in supine position. Reference values for lumbar cerebrospinal fluid pressure were 7.2 to 16.8 mmHg and 5.7 to 15.5 mmHg in the lateral recumbent position and supine position, respectively. ConclusionsThis systematic review is the first to provide position-dependent reference values for intracranial pressure and lumbar cerebrospinal fluid pressure. Clinically applicable reference values for normal lumbar cerebrospinal fluid pressure was established, and were in accordance with previously used reference values. For intracranial pressure, this study strongly emphasizes the scarse normal material, and highlights the need for further research on the matter.

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