Kalin E M, Tweed W A, Lee J, MacKeen W L
N Engl J Med. 1975 Nov 13;293(20):1013-6. doi: 10.1056/NEJM197511132932003.
To study metabolic changes in the central nervous system after profound anoxia, we measured changes in cisternal and lumbar cerebrospinal fluid. Acid-base values and electrolyte concentrations were determined in cisternal and lumbar fluid from 12 severely anoxic patients (cardiac arrest), and from 15 within 24 hours after cardiac resuscitation. In the severely anoxia patients the normal cisternal-lumbar pH gradient was reversed, cisternal fluid was more acid (pH 6.815 vs. 6.953), and cisternal potassium concentration was twice that of lumbar (6.7 vs 3.5 mEq per liter). These findings indicate that during anoxia potassium and hydrogen ion flow from brain cells into the brain extracellular fluid, and that acute changes are reflected more accurately by cisternal than by lumbar fluid. In resuscitated patients cisternal fluid was normal, and normal cisternal-lumbar differences were found; thus, the normal milieu of brain cells is rapidly reestablished after resuscitation.
为研究深度缺氧后中枢神经系统的代谢变化，我们测量了枕骨大池和腰段脑脊液的变化。测定了12例严重缺氧患者（心脏骤停）及15例心脏复苏后24小时内患者的枕骨大池和腰段脑脊液的酸碱值及电解质浓度。在严重缺氧患者中，正常的枕骨大池 - 腰段pH梯度发生逆转，枕骨大池液更酸（pH 6.815对6.953），枕骨大池钾浓度是腰段的两倍（每升6.7对3.5毫当量）。这些发现表明，在缺氧期间，钾离子和氢离子从脑细胞流入脑细胞外液，且枕骨大池液比腰段液更能准确反映急性变化。在复苏后的患者中，枕骨大池液正常，且发现了正常的枕骨大池 - 腰段差异；因此，复苏后脑细胞的正常环境迅速重建。
