The patients dying after long terminal phase have acidotic brains; implications for biochemical measurements on autopsy tissue.

Author(s): Hardy JA, Wester P, Winblad B, Gezelius C, Bring G, Eriksson A

Publication: J Neural Transm, 1985, Vol. 61, Page 253-64

PubMed ID: 3989524 PubMed Review Paper? No

Purpose of Paper

Conclusion of Paper

Studies

1. Study Purpose

   The purpose of this study was to investigate the effects of rapidity of death on brain and blood pH and lactic acid concentrations.

   Summary of Findings:

   Cortical pH at autopsy was found to be significantly higher in patient who had a violent (pH=7.1) or unexpected death (pH=6.8), then in the patients who died after an illness either unexpectedly (Intermediate; pH= 4.6) or after a prolonged terminal phase (slow; pH= 6.3). The pH of medulla and cortical samples correlated very highly (r=0.93; p<0.01). A lesser correlation was found between pH in cortical and cerebrospinal fluid (r=0.73; p<0.01) or femoral blood (r=0.58; p<0.05). Decreasing cortical pH at autopsy correlated well with increasing cortical lactic acid concentrations (r=0.63 p<0.01). Thus the authors believe increased lactic acid buildup is largely responsible for the decrease in brain and blood pH. The authors also state no effect of age, gender, PMI, medication or extent of cerebral arteriosclerosis on brain pH was identified In conclusion, the presence of a terminal illness decreases brain pH at least in part due to the buildup of lactic acid.

   Biospecimens

   • Tissue - Brain
   • Bodily Fluid - Blood
   • Bodily Fluid - Cerebrospinal Fluid

   Preservative Types

   • None (Fresh)
   • Frozen

   Diagnoses:

   • Cardiovascular Disease
   • Pneumonia/Respiratory Infection
   • Arteriosclerosis
   • Neoplastic - Carcinoma
   • Neoplastic - Lymphoma
   • Normal
   • Autopsy

   Platform:

   Analyte	Technology Platform
   Small molecule	pH
   Small molecule	Enzyme assay

   Pre-analytical Factors:

   Classification	Pre-analytical Factor	Value(s)
   Preaquisition	Rapidity of death	Expected following terminal illness Sudden trauma Sudden Unexpected following illness
   Preaquisition	Prior patient medical condition	Cerebral arteriosclerosis
   Biospecimen Acquisition	Biospecimen location	Medulla Cerebrospinal fluid Frontal cortex Femoral vein blood

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