Skip to main content
NCBI home page
The Journal of Clinical Investigation logoLink to The Journal of Clinical Investigation
. 1974 Jul;54(1):18–23. doi: 10.1172/JCI107740

Effect of Experimental Pneumococcal Meningitis on Respiration and Circulation in the Rabbit

Malcolm R Sears 1,2,3, J Morgan O'Donoghue 1,2,3, H Kenneth Fisher 1,2,3, Harry N Beaty 1,2,3
PMCID: PMC301520  PMID: 4152001

Abstract

Pathophysiological studies in bacterial meningitis in man have been limited by clinical variability and the necessity for immediate therapy. After the development of a reliable animal model of pneumococcal meningitis, we studied respiration and circulation in 25 anesthetized New Zealand white rabbits during untreated pneumococcal meningitis and in 33 healthy controls. In meningitis, we found increased lactic acid in cerebrospinal fluid (CSF). Increased ventilation, perhaps due to CSF lactic acid accumulation, resulted in respiratory alkalosis; the concomitant lowering of Pco2 acted as a homeostatic mechanism to restore pH toward normality in the CSF. Hyperventilation increased with the duration of the illness. Cardiac output was also increased with decreased peripheral vascular resistance but with only slight reduction in mean systemic and pulmonary arterial pressures. In the final hour of life, peripheral vascular resistance fell further; ventilation declined and then abruptly ceased while cardiac activity continued. Lactic acid accumulation in the CSF, found in both experimental and human pneumococcal meningitis, may cause the hyperventilation found in this disease and may contribute to death.

Full text

PDF
18

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Blayo M. C., Bazin C., Gaudebout C. Etude comparative des pressions partielles gazeuses, des équilibres acido-basique et hydroélectrolytique du liquide céphalo-rachidien des méningites bactériennes de l'adulte. Rev Eur Etud Clin Biol. 1971 Mar;16(3):224–232. [PubMed] [Google Scholar]
  2. COHN Z. A., MORSE S. I. Functional and metabolic properties of polymorphonuclear leucocytes. I. Observations on the requirements and consequences of particle ingestion. J Exp Med. 1960 May 1;111:667–687. doi: 10.1084/jem.111.5.667. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Dalldorf F. G., Pate D. H., Langdell R. D. Pulmonary capillary thrombosis in experimental pneumococcal septicemia. Arch Pathol. 1968 Feb;85(2):149–161. [PubMed] [Google Scholar]
  4. Fisher H. K., Clements J. A. Pulmonary and circulatory effects of human fibrinopeptides. Chest. 1971 May;59(Suppl):3S–6S. [PubMed] [Google Scholar]
  5. Granholm L., Siesjö B. K. The effects of hypercapnia and hypocapnia upon the cerebrospinal fluid lactate and pyruvate concentrations and upon the lactate, pyruvate, ATP, ADP, phosphocreatine and creatine concentrations of cat brain tissue. Acta Physiol Scand. 1969 Mar;75(3):257–266. doi: 10.1111/j.1748-1716.1969.tb04379.x. [DOI] [PubMed] [Google Scholar]
  6. Irwin G. R., Jr Cerebrospinal fluid pH and respiratory rate in bacterial meningitis. Dis Nerv Syst. 1972 Apr;33(4):276–279. [PubMed] [Google Scholar]
  7. Kjällquist A., Siesjö B. K., Zwetnow N. Effects of increased intracranial pressure on cerebral blood flow and on cerebral venous pO2, pCO2, pH, lactate and pyruvate in dogs. Acta Physiol Scand. 1969 Mar;75(3):267–275. doi: 10.1111/j.1748-1716.1969.tb04380.x. [DOI] [PubMed] [Google Scholar]
  8. LUNDHOLM L., MOHME-LUNDHOLM E., VAMOS N. Lactic acid assay with L(plus)lactic acid dehydrogenase from rabbit muscle. Acta Physiol Scand. 1963 Jun-Jul;58:243–249. doi: 10.1111/j.1748-1716.1963.tb02645.x. [DOI] [PubMed] [Google Scholar]
  9. Lamisse F., Grenier B., Choutet P., Rolland J. C., Gautier J. Intérêt du dosage de l'acide lactique dans le liquide rachidien pour le diagnostic des meningites purulentes. Lyon Med. 1972 Nov 26;228(18):591–595. [PubMed] [Google Scholar]
  10. MITCHELL R. A., HERBERT D. A., CARMAN C. T. ACID-BASE CONSTANTS AND TEMPERATURE COEFFICIENTS FOR CEREBROSPINAL FLUID. J Appl Physiol. 1965 Jan;20:27–30. doi: 10.1152/jappl.1965.20.1.27. [DOI] [PubMed] [Google Scholar]
  11. MacLean L. D., Mulligan W. G., McLean A. P., Duff J. H. Patterns of septic shock in man--a detailed study of 56 patients. Ann Surg. 1967 Oct;166(4):543–562. doi: 10.1097/00000658-196710000-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Mellins R. B., Levine O. R., Wigger H. J., Leidy G., Curnen E. C. Experimental menigococcemia: model of overwhelming infection in unanesthetized monkeys. J Appl Physiol. 1972 Mar;32(3):309–314. doi: 10.1152/jappl.1972.32.3.309. [DOI] [PubMed] [Google Scholar]
  13. PERRY J. E., CLUFF L. E. MANIFESTATIONS OF FATAL PNEUMOCOCCAL INFECTION IN RABBITS. J Lab Clin Med. 1963 Oct;62:549–558. [PubMed] [Google Scholar]
  14. POSNER J. B., SWANSON A. G., PLUM F. ACID-BASE BALANCE IN CEREBROSPINAL FLUID. Arch Neurol. 1965 May;12:479–496. doi: 10.1001/archneur.1965.00460290035006. [DOI] [PubMed] [Google Scholar]
  15. Pappenheimer J. R. The ionic composition of cerebral extracellular fluid and its relation to control of breathing. Harvey Lect. 1967;61:71–94. [PubMed] [Google Scholar]
  16. Plum F., Posner J. B. Blood and cerebrospinal fluid lactate during hyperventilation. Am J Physiol. 1967 Apr;212(4):864–870. doi: 10.1152/ajplegacy.1967.212.4.864. [DOI] [PubMed] [Google Scholar]
  17. SBARRA A. J., KARNOVSKY M. L. The biochemical basis of phagocytosis. I. Metabolic changes during the ingestion of particles by polymorphonuclear leukocytes. J Biol Chem. 1959 Jun;234(6):1355–1362. [PubMed] [Google Scholar]
  18. Severinghaus J. W. Blood gas calculator. J Appl Physiol. 1966 May;21(3):1108–1116. doi: 10.1152/jappl.1966.21.3.1108. [DOI] [PubMed] [Google Scholar]
  19. Shoemaker W. C. Cardiorespiratory patterns in complicated and uncomplicated septic shock: physiologic alterations and their therapeutic implications. Ann Surg. 1971 Jul;174(1):119–125. doi: 10.1097/00000658-197107010-00019. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Williams J. C., O'Donovan T. P., Wood E. H. A method for the calculation of areas under indicator-dilution curves. J Appl Physiol. 1966 Mar;21(2):695–699. doi: 10.1152/jappl.1966.21.2.695. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Investigation are provided here courtesy of American Society for Clinical Investigation

RESOURCES