Understanding the role of the cerebrospinal fluid in acid–base disorders
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The importance of acid–base interpretation is witnessed by the bulk of literature constantly being published on the topic [1, 2]. However, none of the recently published papers specifically addresses the acid–base equilibrium of the cerebrospinal fluid (CSF), which is an important compartment, since it influences the activity of the central controllers of respiration.
Here, we will briefly discuss the characteristics of CSF acid–base equilibrium and their implications on the control of breathing, basing our reasoning on Stewart’s approach . Moreover, we will highlight some clinical implications that, we believe, are usually not fully considered by clinicians.
Characteristics of CSF and blood–CSF barrier
According to Stewart’s approach, pH in biologic fluids is independently regulated by three variables: (1) partial pressure of carbon dioxide (PCO2), (2) strong ion difference (SID), the difference between the sum of strong cations and anions, and (3) the concentration...
KeywordsFixed Acid Base Disorder Plasma Chloride Cerebral Fluid Hypocapnic Alkalosis
We are very grateful to Dr. Simone Sosio for graphical assistance.
Compliance with ethical standards
Conflicts of interest
The authors declare no conflict of interest regarding this commentary.
- 15.Langer T, Scotti E, Carlesso E, Protti A, Zani L, Chierichetti M et al (2015) Electrolyte shifts across the artificial lung in patients on extracorporeal membrane oxygenation: interdependence between partial pressure of carbon dioxide and strong ion difference. J Crit Care 30:2–6CrossRefGoogle Scholar