TY - JOUR
T1 - Pro-inflammatory cerebrospinal fluid profile of neonates with intraventricular hemorrhage
T2 - clinical relevance and contrast with CNS infection
AU - Garcia-Bonilla, Maria
AU - Yahanda, Alexander T.
AU - Isaacs, Albert M.
AU - Baksh, Brandon
AU - Akbari, S. Hassan A.
AU - Botteron, Haley
AU - Morales, Diego M.
AU - Han, Rowland H.
AU - McAllister, James P.
AU - Mathur, Amit M.
AU - Strahle, Jennifer M.
AU - Smyser, Christopher D.
AU - Limbrick, David D.
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/12
Y1 - 2024/12
N2 - Background: Interpretation of cerebrospinal fluid (CSF) studies can be challenging in preterm infants. We hypothesized that intraventricular hemorrhage (IVH), post-hemorrhagic hydrocephalus (PHH), and infection (meningitis) promote pro-inflammatory CSF conditions reflected in CSF parameters. Methods: Biochemical and cytological profiles of lumbar CSF and peripheral blood samples were analyzed for 81 control, 29 IVH grade 1/2 (IVH1/2), 13 IVH grade 3/4 (IVH3/4), 15 PHH, 20 culture-confirmed bacterial meningitis (BM), and 27 viral meningitis (VM) infants at 36.5 ± 4 weeks estimated gestational age. Results: PHH infants had higher (p < 0.02) CSF total cell and red blood cell (RBC) counts compared to control, IVH1/2, BM, and VM infants. No differences in white blood cell (WBC) count were found between IVH3/4, PHH, BM, and VM infants. CSF neutrophil counts increased (p ≤ 0.03) for all groups compared to controls except IVH1/2. CSF protein levels were higher (p ≤ 0.02) and CSF glucose levels were lower (p ≤ 0.003) for PHH infants compared to all other groups. In peripheral blood, PHH infants had higher (p ≤ 0.001) WBC counts and lower (p ≤ 0.03) hemoglobin and hematocrit than all groups except for IVH3/4. Conclusions: Similarities in CSF parameters may reflect common pathological processes in the inflammatory response and show the complexity associated with interpreting CSF profiles, especially in PHH and meningitis/ventriculitis.
AB - Background: Interpretation of cerebrospinal fluid (CSF) studies can be challenging in preterm infants. We hypothesized that intraventricular hemorrhage (IVH), post-hemorrhagic hydrocephalus (PHH), and infection (meningitis) promote pro-inflammatory CSF conditions reflected in CSF parameters. Methods: Biochemical and cytological profiles of lumbar CSF and peripheral blood samples were analyzed for 81 control, 29 IVH grade 1/2 (IVH1/2), 13 IVH grade 3/4 (IVH3/4), 15 PHH, 20 culture-confirmed bacterial meningitis (BM), and 27 viral meningitis (VM) infants at 36.5 ± 4 weeks estimated gestational age. Results: PHH infants had higher (p < 0.02) CSF total cell and red blood cell (RBC) counts compared to control, IVH1/2, BM, and VM infants. No differences in white blood cell (WBC) count were found between IVH3/4, PHH, BM, and VM infants. CSF neutrophil counts increased (p ≤ 0.03) for all groups compared to controls except IVH1/2. CSF protein levels were higher (p ≤ 0.02) and CSF glucose levels were lower (p ≤ 0.003) for PHH infants compared to all other groups. In peripheral blood, PHH infants had higher (p ≤ 0.001) WBC counts and lower (p ≤ 0.03) hemoglobin and hematocrit than all groups except for IVH3/4. Conclusions: Similarities in CSF parameters may reflect common pathological processes in the inflammatory response and show the complexity associated with interpreting CSF profiles, especially in PHH and meningitis/ventriculitis.
KW - Bacterial Meningitis
KW - CNS infection
KW - Cerebrospinal fluid
KW - Intraventricular hemorrhage
KW - Post-hemorrhagic hydrocephalus
KW - Prematurity
KW - Viral meningitis
UR - http://www.scopus.com/inward/record.url?scp=85185463674&partnerID=8YFLogxK
U2 - 10.1186/s12987-024-00512-0
DO - 10.1186/s12987-024-00512-0
M3 - Article
C2 - 38383424
AN - SCOPUS:85185463674
SN - 2045-8118
VL - 21
JO - Fluids and barriers of the CNS
JF - Fluids and barriers of the CNS
IS - 1
M1 - 17
ER -