Journal of Applied Physiology  AJP: Regulatory, Integrative and Comparative Physiology
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J Appl Physiol 54: 3-12, 1983;
8750-7587/83 $5.00
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Journal of Applied Physiology, Vol 54, Issue 1 3-12, Copyright © 1983 by American Physiological Society


ARTICLES

Ionic mechanisms of cerebrospinal fluid acid-base regulation

E. E. Nattie

This review emphasizes the importance of strong ions in the regulation of cerebrospinal fluid (CSF) acid-base balance. In a solution like CSF that is devoid of nonbicarbonate buffers. [H+] and [HCO-3] are dependent variables, the independent variables being the CO2 partial pressure (PCO2) and the strong ion difference. Any measureable changes in CSF [HCO-3] and any change in [H+] that occur independent of changes in PCO2 must be accompanied by, if not caused by, changes in strong ions. The role of H+ and HCO-3 vs. strong ions in the ionic mechanisms of CSF acid-base regulation is unknown. For example, these mechanisms could depend only on changes in strong ions that accompany acid-base disorders, or they could be triggered by changes in [H+] or PCO2. These ideas are presented within the context of current concepts concerning the relationship of CSF to brain interstitial fluid (ISF) and the importance of choroid plexus and blood-brain barrier mechanisms in determining CSF and ISF ionic composition. Studies concerning CSF strong ions in normal and abnormal acid-base states are reviewed.


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Hypoproteinemia, strong-ion difference, and acid-base status in critically ill patients
J Appl Physiol, May 1, 1998; 84(5): 1740 - 1748.
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