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Neonatal Cerebrospinal Fluid Glucose Estimation Using Glucometers: Feasibility and Validity

Nirupam, Nilay MD; Nangia, Sushma MD, DM; Saili, Arvind MD

Point of Care: The Journal of Near-Patient Testing & Technology: September 2015 - Volume 14 - Issue 3 - p 88–91
doi: 10.1097/POC.0000000000000054
Original Articles

Background The diagnosis of neonatal meningitis requires prompt cerebrospinal fluid (CSF) analysis. Bedside CSF glucose estimation by “point-of-care testing” if feasible, in conjunction with CSF cytology, will help in immediate bedside diagnosis of meningitis. The aims of study were to assess feasibility of bedside CSF glucose estimation in neonates, using amperometric glucometer (AG) and photometric glucometer (PG), and to evaluate its utility in diagnosis of meningitis.

Methods This prospective study enrolled 50 consecutive neonates suspected of meningitis. The CSF glucose estimated using PG and AG was evaluated against standard laboratory estimation (criterion standard) performed within 30 minutes of lumbar puncture.

Results Of the 50 neonates, 13 (26%) were confirmed to have meningitis. The difference in CSF glucose value between laboratory and PG ranged from 20 to 120 mg/dL and between laboratory and AG ranged from 3 to 11 mg/dL, being higher with the glucometers. In proven meningitis, the difference with AG was just 3 to 7 mg/dL. All cases of CSF hypoglycorrhachia (n = 13) and those reported normal by laboratory (n = 37) were detected correctly by AG.

Conclusions Glucometers can measure CSF glucose. Amperometric glucometer can serve as a potential tool for bedside CSF glucose estimation in neonatal units.

From the Department of Neonatology, Lady Hardinge Medical College, Kalawati Saran Children's Hospital, New Delhi, India.

Reprints: Nilay Nirupam, MD, Department of Neonatology, Lady Hardinge Medical College, Shaheed Bhagat Singh Marg, New Delhi 110001, India. E-mail:

The authors declare no conflict of interest.

The conception and design of the study was by S.N. Meanwhile, N.N. was involved in data collection, analysis, and drafting the manuscript. A.S. and S.N. provided critical revision of the manuscript for important intellectual content and final approval of the version to be published.

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