Send to:

Choose Destination
See comment in PubMed Commons below
Arch Dis Child Fetal Neonatal Ed. 2010 Jan;95(1):F25-9. doi: 10.1136/adc.2008.150292. Epub 2009 Aug 10.

Effect of delay in analysis on neonatal cerebrospinal fluid parameters.

Author information

  • 1Department of Pediatrics, PGIMER, Chandigarh 160012, India.



The effect of delayed analysis on cerebrospinal fluid (CSF) white blood cell (WBC) count and glucose has never been studied in neonates.


Prospective cohort study.


Level III newborn unit.


Neonates undergoing lumbar puncture were enrolled after consent. CSF was analysed at baseline (30 minutes) for protein, WBC and glucose; and from the same sample for WBC and glucose after a lag of 2 h and 4 h after lumbar puncture. Those with traumatic/inadequate CSF were excluded. Subjects were classified in three groups (n = 20 each) based on baseline WBC count: no WBC, 1-30 WBC and >30 WBC/microl. Analysis was by repeated-measures ANOVA.


There was a significant decline in mean (SD) CSF glucose from baseline to 2 h and 4 h (41.0 (19) to 38.3 (19) and 36.2 (20) mg/dl, respectively) and WBC count (36 (45) to 28.6 (38) and 23.8 (34) cells/microl, respectively; both p<0.001). CSF glucose and WBC declined in all three groups (p<0.001). High baseline CSF WBC (p<0.001) and protein (p<0.001) was associated with a more rapid decline in the levels of CSF WBC, but not glucose. True CSF parameters could be predicted from 4-h parameters: "baseline glucose 5.4 + 0.98 (4-h glucose)" (adjusted R(2) 97.2%, p<0.001) and "baseline WBC 1.3 (4-h WBC) +0.05 (protein)" (adjusted R(2) 98.8%, p<0.001). In group 3, a diagnosis of meningitis (based on pleocytosis) would be missed in 52.6% and 78.9% subjects at 2 h and 4 h, respectively.


CSF WBC count and glucose decrease significantly with time. Reliance on WBC counts of delayed samples can result in underdiagnosis.

[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for HighWire
    Loading ...
    Write to the Help Desk