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Der Säure-Basenstatus des Liquor cerebrospinalis und seine Regulation durch die Lungenventilation

The acid-base status of cerebrospinal fluid and its regulation by the ventilation of the lungs

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Summary

Cerebrospinal fluid (CSF) is not a homogeneous fluid. Slight differences between cisternal and lumbar CSF have been described in literature. The fluid produced by the choroid plexuses is not identical with the fluid in the cavities, especially differences in pCO2 and bicarbonate are to be expected. Though there is continuity between the CSF and the extracellular fluid of the brain, gradients of ion concentrations may develop between these two fluids. The role of the potentials between blood and CSF for the ion exchange is discussed as well as the sources of this potential. The data of the literature on CO2 dissociation in CSF are collected and the theory of CO2 dissociation, mainly following van Heijstet al. (1966), is discussed and a diagram is presented. The buffering against fixed acid depends almost entirely on the bicarbonate of CSF. Recent data of the literature on bicarbonate exchange between blood and CSF are discussed. This exchange is considered as the basis on which the regulation by a feedback regulator acts which consists of the central and peripheral chemoreceptors as sensing elements, the respiratory centers as actuator and the lung ventilation as controlling element. The regulator under normal conditions and in metabolic acidosis-alkalosis controls the pH of the extracellular fluid of the brain thus providing a constant environment for the nerve cells of the brain. This may serve their reproducibility in their action as the elements of a computer. Deviations occur during inhalation of CO2 and in hypoxia.

Zusammenfassung

Liquor cerebrospinalis ist keine homogene Flüssigkeit. Geringe Differenzen zwischen zisternalem und lumbalem Liquor wurden in der Literatur beschrieben. Die vom Plexus chorioideus gelieferte Flüssigkeit ist nicht identisch mit der Flüssigkeit in den Liquorräumen, insbesondere müssen Unterschiede im CO2-Druck und der Bicarbonatkonzentration angenommen werden. Obwohl eine Kontinuität zwischen Liquor und extracellulärer Flüssigkeit des Gehirns besteht, können sich Gradienten der Ionenkonzentration zwischen beiden Flüssigkeiten entwickeln. Die Rolle der Potentiale zwischen Blut und Liquor für den Ionenaustausch und die Quellen dieses Potentials werden diskutiert. Die Daten der Literatur über die CO2-Dissoziation im Liquor werden mitgeteilt und die Theorie der CO2-Dissoziation wird im Anschluß an van Heijst et al. (1966) diskutiert. Ein Diagramm wird vorgelegt. Die Pufferung gegen fixe Säuren ist fast ausschließlich von der Bicarbonatkonzentration des Liquors abhängig. Neue Daten der Literatur über den Austausch von Bicarbonat zwischen Blut und Liquor werden diskutiert. Dieser Austausch wird als die Basis angesehen, auf der ein Regler mit negativer Rückkoppelung arbeitet, bestehend aus zentralen und peripheren Chemoreceptoren als Fühler, den Atemzentren als Schalter und der Lungenventilation als Stellglied. Unter normalen Bedingungen und bei metabolischer Acidose-Alkalose kontrolliert der Regler das pH der extracellulären Flüssigkeit des Gehirns und sorgt dadurch für die Konstanz der Umgebung der Nervenzellen des Gehirns. Dies dient deren Reproduzierbarkeit bei ihrer Tätigkeit als Elemente eines Computers. Abweichungen kommen vor bei Einatmung von CO2 und in der Hypoxie.

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  1. Institut für Physiologie der Ruhr-Universität Bochum, Germany

    Hans H. Loeschcke

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Unter Verwendung eines Vortrags „The acid base status of cerebrospinal fluid and the regulation of breathing“, gehalten auf dem Symposium über “Regulation of Respiration and acid base balance“ im Rahmen des XXV. Internat. Kongresses der Physiol. Wissenschaften, München, 1971.

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Loeschcke, H.H. Der Säure-Basenstatus des Liquor cerebrospinalis und seine Regulation durch die Lungenventilation. Klin Wochenschr 50, 581–593 (1972). https://doi.org/10.1007/BF01488776

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