Arterial blood--spinal fluid oxygen gradient diminishes during alkalaemia in hyperoxic man

We investigated the effect of intravenous sodium bicarbonate (2 mmol x kg-1) on the arterial blood-spinal fluid PO2 gradient in twelve anaesthetized hyperoxaemic human subjects who were in preparation for surgical procedures The steady-state samples of arterial blood and lumbar fluid were withdrawn for the assessment of the acid-base status and electrolyte content in both fluid compartments before and after NaHCO3 injection. We found that NaHCO3 increased the arterial pH and PCO2, and decreased the blood-spinal fluid PO2 gradient significantly. The latter was a result of an increase in spinal fluid PO2 and a decrease in PaO2. The diminished PO2 gradient can be accounted for by the specific effect of carbamate and bicarbonate, distinct from that of pH, lowering the affinity of haemoglobin for oxygen. This might favor the maintenance of an adequate oxygen supply in the brain tissue under unfavorable conditions.