Cerebrospinal fluid protein reactions during non-neurological surgery.
OBJECTIVE
To study changes in cerebrospinal fluid (CSF) protein markers of blood-CSF barrier integrity and immunological reactions during surgical stress.


METHODS
Thirty-five patients without neurological or psychiatric disorders undergoing knee replacements had CSF and serum samples drawn from spinal and arterial catheters before, 3 h after and the morning after surgery.


RESULTS
Serum albumin decreased during surgery and CSF albumin decreased during and after surgery, and, as a consequence, the CSF/serum albumin ratio decreased significantly during the study period, especially after the intervention. In contrast, CSF concentrations of beta-2-microglobuline (beta2M) increased significantly during surgery and remained high. The CSF general marker beta-trace protein (betaTP) remained unchanged.


CONCLUSIONS
Central nervous system protein reactions to a non-neurological surgical intervention include sharply decreased permeability of albumin into the CSF and signs of intrathecal inflammatory activity.
Anckarsäter
R
R
Department of Anaesthesiology and Intensive Care, Kungälv Hospital, Kungälv, Sweden.
Vasic
N
N
Jidéus
L
L
Kristiansson
M
M
Zetterberg
H
H
Blennow
K
K
Anckarsäter
H
H
D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D002556:Cerebrospinal Fluid Proteins / Q000378:metabolism*; D005260:Female; D006801:Humans; D019746:Intramolecular Oxidoreductases / Q000097:blood / Q000134:cerebrospinal fluid*; D007432:Intraoperative Period; D054834:Lipocalins; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012709:Serum Albumin / Q000378:metabolism*; D013312:Stress, Physiological / Q000097:blood / Q000134:cerebrospinal fluid* / Q000209:etiology; D001613:beta 2-Microglobulin / Q000097:blood / Q000134:cerebrospinal fluid*
D002556:Cerebrospinal Fluid Proteins; D054834:Lipocalins; D012709:Serum Albumin; D001613:beta 2-Microglobulin; D019746:Intramolecular Oxidoreductases; C022466:prostaglandin R2 D-isomerase