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Published on: November 10, 2008
Cerebrospinal fluid protein reactions during non-neurological surgery
R Anckarsäter1, N Vasic, L Jidéus
1Department of Anaesthesiology and Intensive Care, Kungälv Hospital, Kungälv, Sweden.
Objective:
To study changes in cerebrospinal fluid (CSF) protein markers of blood-CSF barrier integrity and immunological reactions during surgical stress.
Subjects And 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.
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