Comparison of cisternal and lumbar cerebrospinal fluid pH in high altitude natives

Samples of cisternal or lumbar cerebrospinal fluid were obtained from 20 young male volunteers born and living at high altitude (3500 to 4800 m). The pH, carbon dioxide and oxygen tensions, and bicarbonate concentration were measured and compared with those in the arterial and jugular venous blood. A consistent difference between the two CSF compartments was noted, particularly a lower pH (0.05), a higher PCO2 (7 Torr), and a lower PO2 (7 Torr) at the lumbar site. Mean bicarbonate concentration was not significantly different at the two sites. The main factor is PCO2, which controls the pH variation. These differences were more marked in high-altitude natives than in man at sea level. The existence of a consistent inhomogeneity of CSF acid-base content emphasizes the inaccuracy of using lumbar CSF pH to estimate the ECF pH as regulator of pulmonary ventilation and determinant of cerebral blood flow.