Department of Pediatric Intensive Care, BC Children's Hospital, Vancouver, British Columbia, Canada.
Division of Infectious and Immunological Diseases, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada.
Am J Perinatol. 2018 Jul;35(8):764-768. doi: 10.1055/s-0037-1615794. Epub 2017 Dec 29.
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.
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.
A total of 1,263 LPs were reviewed, 47.7% ( = 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 ( = - 2.884, = 0.004). None of the other factors studied was associated with traumatic taps. Detected organisms included ( = 12), coagulase-negative ( = 7), ( = 3), and group B ( = 2).
Nearly half of all CSF samples in the study period were contaminated. Traumatic samples were more common in younger neonates.
新生儿腰椎穿刺（LP）过程中脑脊液（CSF）污染血液的情况较为常见，给诊断带来困难。我们的目的是确定在 BC 儿童医院 9 年内进行的创伤性 LP 数量，以及创伤性 LP 是否与人口统计学变量、医院位置或手术时间有关。
这是一项对 2006 年 5 月至 2015 年 3 月间新生儿 CSF 样本的回顾性研究。分析数据以确定创伤性样本的发生率，以及创伤性 LP 是否与人口统计学变量（年龄、性别）、手术部位、CSF 培养阳性和/或手术时间有关。
共回顾了 1263 例 LP，47.7%（ = 602）的样本中红细胞/高倍视野>400。无污染样本的新生儿中位年龄为 10.580 天，而污染样本的中位年龄为 6.535 天（ = -2.884， = 0.004）。其他研究因素均与创伤性 LP 无关。检测到的病原体包括 （ = 12）、凝固酶阴性 （ = 7）、 （ = 3）和 B 群 （ = 2）。
研究期间近一半的 CSF 样本均受到污染。创伤性样本更常见于年龄较小的新生儿。
