Traumatic Neonatal Lumbar Punctures: Experience at a Large Pediatric Tertiary Care Center in Canada.
Am J Perinatol
; 35(8): 764-768, 2018 07.
Article
in En
| MEDLINE
| ID: mdl-29287293
ABSTRACT
OBJECTIVE:
Contamination of cerebrospinal fluid (CSF) by blood during neonatal lumbar puncture (LP) is common and poses diagnostic difficulties. Our objectives were to determine the number of traumatic LPs performed at the BC Children's Hospital over 9 years and whether there was an association between traumatic LPs and demographic variables, hospital location, or time of the procedure. STUDYDESIGN:
This study was a retrospective review of neonatal CSF samples from May 2006 to March 2015. The data were analyzed to establish the rate of traumatic samples and whether there was an association between traumatic LPs and demographic variables (age, gender), location of procedure, positive CSF culture, and/or timing of the procedure.RESULTS:
A total of 1,263 LPs were reviewed, 47.7% (n = 602) were contaminated with >400 red blood cells/high-power field. The median age of neonates whose samples were uncontaminated was 10.580 days compared with 6.535 days in the group with contaminated samples (z = - 2.884, p = 0.004). None of the other factors studied was associated with traumatic taps. Detected organisms included Escherichia coli (n = 12), coagulase-negative Staphylococcus (n = 7), Enterococcus faecalis (n = 3), and group B Streptococcus (n = 2).CONCLUSION:
Nearly half of all CSF samples in the study period were contaminated. Traumatic samples were more common in younger neonates.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Spinal Puncture
/
Cerebrospinal Fluid
/
Erythrocyte Count
Type of study:
Observational_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
/
Male
/
Newborn
Country/Region as subject:
America do norte
Language:
En
Journal:
Am J Perinatol
Year:
2018
Type:
Article
Affiliation country:
Canada