Abstract
CSF protein levels performed during the second week of life can predict the presence of IVH of grade II-IV as scaled by Papille, et al. A screening test for IVH would be useful in those nurseries that do not have portable ultrasound capabilities and can obtain CAT-scans only with difficulty. In a previous study, RBC counts in CSF fluid have been determined not to reflect the presence or absence of IVH (Silverboard, et al.).
Twenty-four infants in our NICU had an IVH of grade II-IV diagnosed by CAT-scan. Fifteen of these infants had 33 lumbar punctures (LP) performed during the second week of life, only 4 specimens had CSF protein< 300mg%. All patients had at least one CSF protein value greater than 300mg%. (normal ≤ 140mg%) The presence of many RBCs in CSF (>250,000) negates the validity of the test and 7 specimens were excluded for this reason. A group of 7 prematures with normal CAT-scans had CSF proteins of <300mg% and only 2 values of > 200mg% on LPs performed during their stay. CSF protein values on infants with IVH averaged 156mg% during the first week, 672mg% during the second week and 288mg% beyond the second week of life. One ‘false positive’ occurred in a premature who had a large subarachnoid bleed on CAT-scan. No false negatives have been noted, though they may be expected to occur in small grade II hemorrhages. This is a useful screening tool in nurseries without portable ultrasound capabilities to diagnose IVH.
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Mullett, M., Fakadej, A. & Neal, W. 1593 CEREBRAL SPINAL FLUID (CSF) PROTEIN AS AN INDICATION OF INTRAVENTRICULAR HEMORRHAGE (IVH). Pediatr Res 15 (Suppl 4), 708 (1981). https://doi.org/10.1203/00006450-198104001-01610
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DOI: https://doi.org/10.1203/00006450-198104001-01610