title: Ventricular fluid lactate, pyruvate, bicarbonate and ph in unconscious brain-injured patients subjected to controlled ventilation.
abstract: In 35 unconscious patients suffering from traumatic brain injury and subjected to controlled hyperventilation within 12 hours of the acute trauma, we measured continuously the intraventricular pressure (IVP), ventricular fluid lactate, pyruvate, L/P ratio, pH and bicarbonate during the first 4 posttraumatic days, and related the findings to the clinical course. In patients in whom the follow-up study did not reveal severe mental impairment or dementia, the ventricular fluid lactate never exceeded 4 mmol/litre. In this group, the IVP level never exceeded 40 mmHg/hour, and the mean pressure/day never exceeded 20 mmHg. In half of the patients in whom dementia, vegetative survival or death occurred, ventricular fluid lactate exceeded 4 mmol/litre; the IVP level/hour exceeded 40 mmHg in two of 23 patients, and the mean pressure/day exceeded 20 mmHg in nine of 23 patients. The prognostic value of pyruvate was of less importance, although a significant increase in patients with a poor outcome was seen. No prognostic conclusions could be drawn from ventricular fluid, L/P ratio, pH and bicarbonate.
mesh_terms: D001639:Bicarbonates / Q000134:cerebrospinal fluid*; D001930:Brain Injuries / Q000134:cerebrospinal fluid* / Q000175:diagnosis; D002245:Carbon Dioxide / Q000134:cerebrospinal fluid; D005500:Follow-Up Studies; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007427:Intracranial Pressure; D007773:Lactates / Q000134:cerebrospinal fluid*; D010313:Partial Pressure; D011379:Prognosis; D011773:Pyruvates / Q000134:cerebrospinal fluid*; D012121:Respiration, Artificial; D013997:Time Factors; D014474:Unconsciousness / Q000134:cerebrospinal fluid*
chemical_list: D001639:Bicarbonates; D007773:Lactates; D011773:Pyruvates; D002245:Carbon Dioxide