Document Detail


Evaluation of cerebrospinal fluid parameters in preterm infants with intraventricular reservoirs.
MedLine Citation:
PMID:  22301529     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective:Intraventricular reservoirs (IVRs) are used to drain cerebrospinal fluid (CSF) in neonates with post-hemorrhagic ventricular dilatation (PHVD). The objectives of this case-control study were to evaluate changes in CSF parameters in serial IVR taps and to compare CSF parameters in culture-positive and -negative specimens.Study Design:Clinical and laboratory data from serial (up to 7) reservoir taps at 5- to 8-day intervals were collected on preterm neonates with PHVD and IVR insertion.Result:The median (range) gestational age and birth weight of our cohort (n=52) was 26 (23 to 33) weeks and 796 (450 to 1620) grams. Significant decreases in percentage of CSF neutrophils and protein were noted in later taps, compared with the first tap at insertion of IVR. Five (9.6%) infants had positive CSF cultures on 10 occasions. Compared with negative specimens (n=266), the mean (s.d.) proportion of neutrophils in CSF (55% (33) vs 26% (23)) was significantly higher and ratio of CSF to serum glucose significantly lower (0.19 (0.08) vs 0.29 (0.13)) in culture-positive specimens (n=10). The area under the curve was 0.82 (95% confidence interval (CI) 0.72 to 0.93) for CSF white blood cell (WBC) count, 0.79 (95% CI 0.68 to 0.90) for CSF protein and 0.75 (95% CI 0.56 to 0.95) for percentage of neutrophils. The sensitivities and specificities for diagnosis of infection was 90 and 63% for CSF WBC count > 42 mm(-3), 89 and 58% for CSF protein at > 250 mg dl(-1) and 80 and 67% for CSF neutrophil proportion >31.5%.Conclusion:CSF parameters from IVR taps, specifically proportion of neutrophils and proteins are higher at insertion and progressively normalize over time. Although they vary widely, CSF WBC, protein and neutrophil proportion using higher cut-off values have good sensitivity in the diagnosis of infection.Journal of Perinatology advance online publication, 2 February 2012; doi:10.1038/jp.2011.190.
Authors:
M Bajaj; M Lulic-Botica; G Natarajan
Related Documents :
2773889 - Postdelivery head bleeding in hemophilic neonates. causes and management.
20383839 - Predictors of severe neonatal compromise following caesarean section for clinically dia...
16761529 - The influence of the mode of anaesthesia in the incidence of neonatal morbidity after a...
2246989 - Planned homebirths in south australia 1976-1987.
19925629 - The optimal mode of delivery for the haemophilia carrier expecting an affected infant i...
12623479 - Changing patterns in the management and outcome of breech presentation over a 7-year pe...
3785789 - Failed forceps.
24975499 - Influence of paternal and maternal ethnicity and ethnic enclaves on newborn weight.
11827299 - Exclusive breastfeeding and infant growth studies: reference standards for head circumf...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-02
Journal Detail:
Title:  Journal of perinatology : official journal of the California Perinatal Association     Volume:  -     ISSN:  1476-5543     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8501884     Medline TA:  J Perinatol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Carman and Ann Department of Pediatrics, Wayne State University, Detroit, MI, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Nasal intermittent positive pressure ventilation after surfactant treatment for respiratory distress...
Next Document:  Effect of heparin and other factors associated with complications of peripherally inserted central v...