[Disorders of acid-base equilibrium in the cerebrospinal fluid after intracranial operations]

The authors collected 27 patients after intracranial operations in whom the cerebrospinal fluid was investigated at least 3 times during 10 days. The patients were divided into 2 groups--a group of 16 patients with favourable outcome, and a group of 11 patients who died. On the basis of arithmetical means of pCO2 and HCO3 values hypothetical curves of the course of acid-base equilibrium in the blood and cerebrospinal fluid were plotted in both groups during 10 days. In the initial period metabolic acidosis was found in the cerebrospinal fluid and respiratory alkalosis in the blood in both groups. After several days metabolic alkalosis developed in the group of patients with favourable outcome while the metabolic acidosis in the cerebrospinal fluid was balanced. In the group with unfavourable outcome metabolic alkalosis in the blood was less evident and metabolic acidosis in the cerebrospinal fluid was increased. The authors think that metabolic alkalosis in the blood has a compensatory effect on metabolic acidosis in the cerebrospinal fluid and brain.