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- Title
Cerebrospinal fluid spectrophotometry. Do we need to hurry?
- Authors
P., Broz; D., Rajdl; J., Racek; J., Zenkova; V., Petrikova
- Abstract
Introduction: Cerebrospinal fluid (CSF) spectrophotometry (SPFM) is a laboratory assessment used in diagnostics of subarachnoid hemorrhage, mainly in cases when it is not proven by computed tomography (CT), but clinical manifestations still persists. Sample of CSF for SPFM examination should be delivered to the laboratory and analyzed as soon as possible, at least within 1 hour. In delay, the superanatant should be stored at 4°C in dark. The aim of the study was to investigate the consequence of delayed processing of CSF samples in SPFM assessment. Methodology: A total of 48 samples delivered to the laboratory until 30 minutes from lumbar puncture. Collection were enrolled in the study. If a sufficient amount of CSF was obtained, the sample was divided into two aliquots (A and B). In the first aliquot (A), routine biochemical and cytological examination, including erythrocyte counting, was performed. SPFM examination was immediately performed on the centrifuged aliquot. Values of net oxyhemoglobin absorbance (NOA) and net bilirubin absorbance (NBA) were calculated according to the UK recommendation. Aliquot "B" was stored at room temperature for 60 minutes in the light, then centrifuged and SPFM determination was performed as in aliquot "A". A Wilcoxon non-parametric test (paired version) was used for comparisons between groups (group A and B). Results were considered statistically significant at P < 0.05. Upon NOA and NOB, samples were classified as "positive", "negative" and "inconclusive". MedCalc software was used for statistic evaluation. Results: Median erythrocyte count was 16/µL (0-119 460). In 27 (56%) samples, there was a detectable amount of oxyhemoglobin and/or bilirubin. Changes in NOA and NBA levels in samples A in comparison with samples B did not reach statistical significance (P = 0.68 and 0.21, respectively). We found one case classified as "positive" when processed immediately, but an aliquot that was processed after a delay was classified as "inconclusive". The samples with median (min-max) of erythrocyte counting 16/µl (0-119 460) were used. Changes in values of NOA in aliquots analyzed immediately compare to values of samples analyzed after 60 minutes did were not statistically significant (values of median [min-max]): NOA (0 min) = 0.001 (0.001-0.863), NOA (60 min) = 0.001 (0.001-0.898), p=0.67. In case of NBA aliquots with 60 min delay there also were no statistically significant changes: NBA (0 min) = 0.001 (0.001-0.599), NBA (60 min) = 0.001 (0.001-0.601), p=0.12. In classification of samples to groups „positive", „negative" and „inconclusive" there was, in samples with 60 min delay, the change in classification from group „positive" to „inconclusive" in one sample with limit value of NBA. Conclusion: Significant differences in values NOA and NBA were not detected in samples analyzed with 60 min delay compare to those analyzed immediately after collection. In case of limit values of NOA and NBA there is necessary to pay attention in situations of delay in delivery for the sample to laboratory more than 60 minutes.
- Subjects
CEREBROSPINAL fluid examination; SPECTROPHOTOMETRY; SUBARACHNOID hemorrhage; DIAGNOSIS
- Publication
Klinická Biochemie a Metabolismus, 2017, Vol 25, Issue 4, p186
- ISSN
1210-7921
- Publication type
Article