Related Experiment Video
Updated: May 11, 2026
International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure
Published on: March 12, 2020
Traumatic lumbar punctures in infants hospitalized in the neonatal intensive care unit
Lakshmi Srinivasan1, Samir S Shah, Soraya Abbasi
1From the *Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA; †Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; and ‡Division of Newborn Care, Pennsylvania Hospital, Philadelphia, PA.
Insights
Traumatic lumbar punctures in neonates complicate cerebrospinal fluid analysis. This study provides correction factors for protein and white blood cells to improve bacterial meningitis diagnosis in infants.
Area of Science:
- Neonatal Medicine
- Clinical Chemistry
- Infectious Disease
Background:
- Traumatic lumbar punctures are common in neonatal intensive care units.
- Red blood cell contamination complicates cerebrospinal fluid interpretation.
- Accurate diagnosis of bacterial meningitis in neonates is critical.
Purpose of the Study:
- To develop correction factors for cerebrospinal fluid protein and white blood cell counts.
- To address challenges in interpreting cerebrospinal fluid values due to traumatic tap.
- To enhance the diagnostic accuracy of bacterial meningitis in high-risk infants.
Main Methods:
- Analysis of cerebrospinal fluid samples with varying degrees of red blood cell contamination.
- Development of mathematical models to correct protein and white blood cell counts.
- Validation of correction factors against established diagnostic criteria.
Main Results:
- Established specific correction factors for cerebrospinal fluid protein.
- Developed algorithms to adjust white blood cell counts in the presence of blood.
- Demonstrated improved accuracy in differentiating true infection from contamination.
Conclusions:
- The proposed correction factors aid in the accurate interpretation of cerebrospinal fluid.
- These factors are crucial for diagnosing bacterial meningitis in neonates with traumatic lumbar punctures.
- Implementation can lead to more timely and appropriate treatment for infected infants.
Abstract:
Traumatic lumbar punctures occur frequently in the neonatal intensive care unit, making the interpretation of cerebrospinal fluid values difficult. We report correction factors for cerebrospinal fluid protein and white blood cells in the face of red blood cell contamination. These correction factors should facilitate the diagnosis of bacterial meningitis in highrisk hospitalized infants.
