Investigation of cerebrospinal fluid electrolytes and acid-base expressions in Asian adults

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In previous literature, reference values for CSF may be based on patients who were not truly healthy, other species, or outdated information.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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Reference values for nucleosides and nucleobases in cerebrospinal fluid of children.

Clinical Chemistry ◽

10.1093/clinchem/34.7.1439 ◽

1988 ◽

Vol 34 (7) ◽

pp. 1439-1442 ◽

Cited By ~ 9

Author(s):

G P Gerrits ◽

A A Haagen ◽

R A De Abreu ◽

L A Monnens ◽

F J Gabreëls ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Uric Acid ◽

Lumbar Puncture ◽

Reference Values ◽

Normal Values ◽

Age Dependency ◽

Clinical Indications ◽

Different Ages ◽

Diagnostic Lumbar Puncture ◽

Purines And Pyrimidines

Abstract Disturbances in the metabolism of purines and pyrimidines in neurologically affected patients can be reflected by aberrant concentrations of nucleosides and nucleobases in cerebrospinal fluid (CSF). However, normal values, especially for children at different ages, are lacking. We collected 1000 specimens of CSF from subjects ranging in age from newborn to 18 years, who were undergoing a diagnostic lumbar puncture for several clinical indications. Of these, 78 samples could be used retrospectively as a reference according to our criteria. The analyses were performed with a modified HPLC procedure. None of the substances shows age-dependency except uridine and uric acid. Uridine increases with age, and uric acid increases with age in boys older than 12 years.

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Fibrinolytic Activity of Cerebro-Spinal Fluid and the Development of Artificial Cerebral Haematomas in Dogs

Thrombosis and Haemostasis ◽

10.1055/s-0038-1653538 ◽

1969 ◽

Vol 21 (02) ◽

pp. 294-303 ◽

Cited By ~ 3

Author(s):

H Mihara ◽

T Fujii ◽

S Okamoto

Keyword(s):

Cerebrospinal Fluid ◽

Carboxylic Acid ◽

Fibrinolytic Activity ◽

Clinical Implications ◽

Trans Form ◽

Plate Method ◽

Blood Samples ◽

Fibrin Plate ◽

The Brain

SummaryBlood was injected into the brains of dogs to produce artificial haematomas, and paraffin injected to produce intracerebral paraffin masses. Cerebrospinal fluid (CSF) and peripheral blood samples were withdrawn at regular intervals and their fibrinolytic activities estimated by the fibrin plate method. Trans-form aminomethylcyclohexane-carboxylic acid (t-AMCHA) was administered to some individuals. Genera] relationships were found between changes in CSF fibrinolytic activity, area of tissue damage and survival time. t-AMCHA was clearly beneficial to those animals given a programme of administration. Tissue activator was extracted from the brain tissue after death or sacrifice for haematoma examination. The possible role of tissue activator in relation to haematoma development, and clinical implications of the results, are discussed.

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Acute reduction of cerebrospinal fluid volume prior to spinal anesthesia: implications for sensory block extent

Minerva Anestesiologica ◽

10.23736/s0375-9393.20.14138-5 ◽

2020 ◽

Vol 86 (6) ◽

Author(s):

Martin F. Bjurström ◽

Niklas Mattsson ◽

Andreas Harsten ◽

Nicholas Dietz ◽

Mikael Bodelsson

Keyword(s):

Cerebrospinal Fluid ◽

Spinal Anesthesia ◽

Sensory Block ◽

Fluid Volume ◽

Cerebrospinal Fluid Volume

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Reference Values for Transverse Cerebellar Diameter Throughout Gestation

Pediatric and Developmental Pathology ◽

10.1007/s10024-001-0262-4 ◽

2002 ◽

Vol 5 (5) ◽

pp. 489-494 ◽

Cited By ~ 7

Author(s):

Halit Pinar ◽

Sarah H. Burke ◽

Carol W. Huang ◽

Don B. Singer ◽

C. James Sung

Keyword(s):

Reference Values ◽

Growth Curve ◽

Gestational Age ◽

Normal Values ◽

Growth Restriction ◽

Reliable Indicator ◽

Transverse Diameter ◽

Reliable Parameter ◽

Gestational Week ◽

Duration Of Gestation

The transverse cerebellar diameter (TCD) is well established in the ultrasound literature as a reliable parameter for estimating the duration of gestation. In cases of growth restriction the cerebellum is usually spared, making TCD a reliable indicator of gestational age even when other parameters fall off the appropriate growth curve. The purpose of this study is to establish normal values for the transverse diameter of the cerebellum in pathology specimens, and to determine if these values correlate with those obtained by ultrasound. We examined 96 specimens ranging from 14 to 42 weeks gestational age and found that our values correlate well with those published in the ultrasound literature. Mean TCD with 2 standard deviations for each gestational week were determined as reference values.

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

The Pediatric Infectious Disease Journal ◽

10.1097/00006454-199207000-00015 ◽

1992 ◽

Vol 11 (7) ◽

pp. 589-590 ◽

Cited By ~ 64

Author(s):

William A. Bonadio ◽

Lynn Stanco ◽

Robert Bruce ◽

Darcy Barry ◽

Douglas Smith

Keyword(s):

Cerebrospinal Fluid ◽

Reference Values ◽

Fluid Composition

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Osmolal and Anion Gaps in Patients Admitted to an Emergency Medical Department

Human & Experimental Toxicology ◽

10.1177/096032719401300212 ◽

1994 ◽

Vol 13 (2) ◽

pp. 131-134 ◽

Cited By ~ 51

Author(s):

Lars Aabakken ◽

Kjerstin S. Johansen ◽

Else-Berit Rydningen ◽

Jan E. Bredesen ◽

Steinar Øvrebø ◽

...

Keyword(s):

Standard Deviation ◽

Ethylene Glycol ◽

Reference Values ◽

Medical Department ◽

Blood Samples ◽

Emergency Medical ◽

Unselected Population ◽

The Mean ◽

Lactate Levels ◽

Osmolal Gap

1 Osmolal and anion gaps are helpful in the diagnosis and evaluation of intoxications with methanol and ethylene glycol. Reported reference values for osmolal gap and anion gap are -1 (± 6) mosm kg-1 H2O and 16 (± 2) mmol I -1, respectively. However, we have repeatedly found unexplained increased gaps in patients admitted to our department, and the relevance of the established reference values has been questioned. 2 Osmolal and anion gaps were determined in an unselected population of patients consecutively admitted to an emergency medical department. In the case of unexplained gaps, the blood samples were analysed with respect to the presence of alcohols and organic acids. 3 We included all accessible patients admitted during 14 days. Appropriate blood samples were obtained in 177 patients (88 male, 89 female), with a mean age of 65 years (range 17-94). 4 The mean and (standard deviation) for osmolal and anion gaps in our material were 5.2 mosm kg-1 H2O (7.0) and 12.9 mmol/l (4.2). Neither methanol nor ethylene-glycol was detected in serum from any patients. Small amounts of ethanol were found in 5 patients, and high lactate levels explained in part the most extensively increased anion gaps. However, the calculated analytical standard deviation accounted entirely for the variation in our material, and we suggest that the present reference values be adjusted.

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Comparative study of i-SENS glucometers in neonates using capillary blood samples

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2020-1367 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Ha Nui Kim ◽

Soo-Young Yoon

Keyword(s):

Reference Values ◽

Point Of Care ◽

Evaluation Process ◽

Capillary Blood ◽

Performance Criteria ◽

Accuracy Evaluation ◽

Blood Samples ◽

Average Reference ◽

Error Grid ◽

Accuracy Performance

Abstract Objectives The accuracy of point-of-care blood glucometers in the detection and evaluation of neonatal hypoglycemia is a concern. This study compared the performance of three i-SENS glucometers with that of the YSI 2300 STAT Plus Analyzer, which was used as a reference. Methods The leftover neonatal capillary blood samples of 319 patients were used in this study. The evaluation process and accuracy performance criteria were based on the International Organization for Standardization 15197:2013 guidelines. The evaluation involved three i-SENS glucometers (BAROzen H Expert plus, CareSens PRO, and CareSens H Beat) and the ACCU-CHEK® Inform II glucometer. Results The accuracy evaluation yielded acceptable results as follows: a) 100 and 100% for BAROzen H Expert plus; 99.8 and 100% for CareSens PRO; 98.7%, and 97.2% for CareSens H Beat glucometers were within the range of ±0.8 mmol/L (15 mg/dL) and ±15% of the average reference values at glucose concentrations <5.55 mmol/L (100 mg/dL) and ≥5.55 mmol/L (100 mg/dL), respectively, and b) all estimated glucose values (100%) were within the zones A and B of Consensus Error Grid for all three i-SENS glucometers. There was good correlation between the glucose values estimated by the glucometers and the reference values (R>0.990). Conclusions This study demonstrated that i-SENS glucometers exhibit acceptable performance and can be used as effective point-of-care devices in neonates.

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CAPACITY OF THYROXINE-BINDING GLOBULIN TO BIND TRIIODOTHYRONINE AND THYROXINE IN MATERNAL AND CORD BLOOD

PEDIATRICS ◽

10.1542/peds.29.3.369 ◽

1962 ◽

Vol 29 (3) ◽

pp. 369-375

Author(s):

William M. Michener ◽

W. Newlon Tauxe ◽

Alvin B. Hayles

Keyword(s):

Cord Blood ◽

Normal Values ◽

Binding Capacity ◽

Quantitative Difference ◽

Maternal Blood ◽

Blood Samples ◽

Thyroxine Binding Globulin

Normal values for the measurement of thyroidal function using the erythrocytic uptake of I131-labeled triiodothyronine and the thyroxine-binding capacity of the inter-alpha globulin were established. Paired maternal and cord blood samples collected at the time of delivery were studied with these methods. The erythrocytic uptake of labeled hormone was increased in cord blood as compared to maternal blood. Cord blood apparently binds exogenous triiodothyronine in a different manner than it does exogenous thyroxine. Whether this is a qualitative or quantitative difference was not shown in this study.

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An Experience of Successful Spinal Anesthesia in a Patient without Cerebrospinal Fluid Flow

Turkiye Klinikleri Journal of Anesthesiology Reanimation ◽

10.5336/anesthe.2020-80240 ◽

2021 ◽

Vol 19 (1) ◽

pp. 46-49

Author(s):

Mehmet Can GEZER ◽

Hakan KOCAOĞLU ◽

Sanem ÇAKAR TURHAN ◽

Fatma Feyhan ÖKTEN

Keyword(s):

Cerebrospinal Fluid ◽

Fluid Flow ◽

Spinal Anesthesia ◽

Cerebrospinal Fluid Flow

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Suitability of Placental Blood Samples of Newborns for Pre-Transfusion Testing

Frontiers in Pediatrics ◽

10.3389/fped.2021.661321 ◽

2021 ◽

Vol 9 ◽

Author(s):

Rana Alissa ◽

Patty D. Williams ◽

Erika L. Baker ◽

Jennifer A. Hipp ◽

Jinous Saremian ◽

...

Keyword(s):

Informed Consent ◽

Categorical Data ◽

Institutional Review Board ◽

Abo Blood Group ◽

Blood Samples ◽

Rhesus Factor ◽

Institutional Review ◽

Antiglobulin Test ◽

Placental Blood ◽

Antibody Screen

Objective: To show concordance between heel stick and placental blood sample pairs for newborns' pre-transfusion testing and to validate placental blood's tube and gel methodology.Methods: Placental samples were collected for pre-transfusion testing at birth from 78 singleton and twin newborns admitted to our Mother–Baby Unit to compare with the results of heel stick samples taken from same newborns. Gestational age ≥35 weeks, weight ≥2,000 g. The study was approved by the Institutional Review Board (IRB). Informed consent was obtained from newborn parents. ABO blood group, Rhesus factor (Rh), direct antiglobulin test (DAT), and antibody screen were performed. Ortho ProVue Analyzer was used for tube and gel methods. McNemar's test for paired categorical data was performed.Results: One hundred percent concordance in 78 pairs for ABO and Rh. Seventy-four pairs were tested for antibodies, 72 were both negative, 1 was both positive, and 1 gave discordant result. Ninety-nine percent concordance, p = 0.999. Sixty-five pairs were both DAT negative, seven were both DAT positive, and six gave discordant results. Ninety-two percent concordance, p = 0.68. Placental blood gave identical results comparing tube with gel methods.Conclusions: Placental blood is suitable for pre-transfusion testing and can replace heel sticks. Placental blood tube and gel methods are validated.

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