Can fetal umbilical venous blood be a reliable source for admission complete blood count and culture in nicu patients?

Rocky Greer, Azif Safarulla, Robin Koeppel, Muhammad Aslam, Fayez M. Bany-Mohammed

Research output: Contribution to journalArticle

Abstract

Background: Minimizing initial neonatal blood draws and their associated pain is important. The placenta has ample fetal blood that is otherwise discarded; obtaining admission laboratory evaluations from fetal umbilical venous blood (FUVB) may provide a suitable alternative. Objective: We hypothesized that obtaining an aerobic bacterial blood culture (BCX) and a complete blood count with manual differential (CBC/diff) from FUVB is feasible and yields results comparable to those obtained directly from the neonate. Study Design: BCX and CBC/diff were attempted on paired samples from FUVB (in the delivery room) and neonatal blood (shortly after NICU admission) of 110 patients. The paired t test, Pearson's correlation coefficient (R), and multivariable linear regression were used for data analysis. Results: Positive BCXs were found in 9 of 108 FUVB samples compared to 1 of 91 neonatal samples. Three out of 9 FUVB cultures were true pathogens, including 2 Escherichia coli and 1 viridans group streptococcus, all with negative corresponding paired neonatal cultures. There was 1 positive neonatal BCX, E. coli, with a negative paired FUVB culture. Neonatal hemoglobin (Hb), platelets (PLT), and white blood cells (WBC) all significantly (p < 0.0001) correlated with the paired FUVB samples (R = 0.50, 0.49, and 0.84, respectively). Hb, PLT, and WBC values were clinically comparable but statistically higher in neonatal blood (the differences were 2.3 g/dL, 30,000 cells/μL, and 2,800 cells/μL, respectively; p < 0.007 for all comparisons). Conclusions: FUVB is suitable for obtaining CBC/diff. FUVB is an appropriate second source for BCX as it yields additional true pathogens. Our findings may support the presence of "culture-negative sepsis" in some neonates.

Original languageEnglish (US)
Pages (from-to)49-58
Number of pages10
JournalNeonatology
Volume115
Issue number1
DOIs
StatePublished - Jan 1 2019
Externally publishedYes

Fingerprint

Umbilicus
Blood Cell Count
Hemoglobins
Leukocytes
Blood Platelets
Delivery Rooms
Escherichia coli
Viridans Streptococci
Patient Admission
Fetal Blood
Placenta
Linear Models
Sepsis
Newborn Infant

Keywords

  • Blood count
  • Blood culture
  • Cord blood
  • Neonatal sepsis
  • Umbilical venous blood

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental Biology

Cite this

Can fetal umbilical venous blood be a reliable source for admission complete blood count and culture in nicu patients? / Greer, Rocky; Safarulla, Azif; Koeppel, Robin; Aslam, Muhammad; Bany-Mohammed, Fayez M.

In: Neonatology, Vol. 115, No. 1, 01.01.2019, p. 49-58.

Research output: Contribution to journalArticle

Greer, Rocky ; Safarulla, Azif ; Koeppel, Robin ; Aslam, Muhammad ; Bany-Mohammed, Fayez M. / Can fetal umbilical venous blood be a reliable source for admission complete blood count and culture in nicu patients?. In: Neonatology. 2019 ; Vol. 115, No. 1. pp. 49-58.
@article{c4951a3da56f450bbd82dd8dae9b6907,
title = "Can fetal umbilical venous blood be a reliable source for admission complete blood count and culture in nicu patients?",
abstract = "Background: Minimizing initial neonatal blood draws and their associated pain is important. The placenta has ample fetal blood that is otherwise discarded; obtaining admission laboratory evaluations from fetal umbilical venous blood (FUVB) may provide a suitable alternative. Objective: We hypothesized that obtaining an aerobic bacterial blood culture (BCX) and a complete blood count with manual differential (CBC/diff) from FUVB is feasible and yields results comparable to those obtained directly from the neonate. Study Design: BCX and CBC/diff were attempted on paired samples from FUVB (in the delivery room) and neonatal blood (shortly after NICU admission) of 110 patients. The paired t test, Pearson's correlation coefficient (R), and multivariable linear regression were used for data analysis. Results: Positive BCXs were found in 9 of 108 FUVB samples compared to 1 of 91 neonatal samples. Three out of 9 FUVB cultures were true pathogens, including 2 Escherichia coli and 1 viridans group streptococcus, all with negative corresponding paired neonatal cultures. There was 1 positive neonatal BCX, E. coli, with a negative paired FUVB culture. Neonatal hemoglobin (Hb), platelets (PLT), and white blood cells (WBC) all significantly (p < 0.0001) correlated with the paired FUVB samples (R = 0.50, 0.49, and 0.84, respectively). Hb, PLT, and WBC values were clinically comparable but statistically higher in neonatal blood (the differences were 2.3 g/dL, 30,000 cells/μL, and 2,800 cells/μL, respectively; p < 0.007 for all comparisons). Conclusions: FUVB is suitable for obtaining CBC/diff. FUVB is an appropriate second source for BCX as it yields additional true pathogens. Our findings may support the presence of {"}culture-negative sepsis{"} in some neonates.",
keywords = "Blood count, Blood culture, Cord blood, Neonatal sepsis, Umbilical venous blood",
author = "Rocky Greer and Azif Safarulla and Robin Koeppel and Muhammad Aslam and Bany-Mohammed, {Fayez M.}",
year = "2019",
month = "1",
day = "1",
doi = "10.1159/000491993",
language = "English (US)",
volume = "115",
pages = "49--58",
journal = "Neonatology",
issn = "1661-7800",
publisher = "S. Karger AG",
number = "1",

}

TY - JOUR

T1 - Can fetal umbilical venous blood be a reliable source for admission complete blood count and culture in nicu patients?

AU - Greer, Rocky

AU - Safarulla, Azif

AU - Koeppel, Robin

AU - Aslam, Muhammad

AU - Bany-Mohammed, Fayez M.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Minimizing initial neonatal blood draws and their associated pain is important. The placenta has ample fetal blood that is otherwise discarded; obtaining admission laboratory evaluations from fetal umbilical venous blood (FUVB) may provide a suitable alternative. Objective: We hypothesized that obtaining an aerobic bacterial blood culture (BCX) and a complete blood count with manual differential (CBC/diff) from FUVB is feasible and yields results comparable to those obtained directly from the neonate. Study Design: BCX and CBC/diff were attempted on paired samples from FUVB (in the delivery room) and neonatal blood (shortly after NICU admission) of 110 patients. The paired t test, Pearson's correlation coefficient (R), and multivariable linear regression were used for data analysis. Results: Positive BCXs were found in 9 of 108 FUVB samples compared to 1 of 91 neonatal samples. Three out of 9 FUVB cultures were true pathogens, including 2 Escherichia coli and 1 viridans group streptococcus, all with negative corresponding paired neonatal cultures. There was 1 positive neonatal BCX, E. coli, with a negative paired FUVB culture. Neonatal hemoglobin (Hb), platelets (PLT), and white blood cells (WBC) all significantly (p < 0.0001) correlated with the paired FUVB samples (R = 0.50, 0.49, and 0.84, respectively). Hb, PLT, and WBC values were clinically comparable but statistically higher in neonatal blood (the differences were 2.3 g/dL, 30,000 cells/μL, and 2,800 cells/μL, respectively; p < 0.007 for all comparisons). Conclusions: FUVB is suitable for obtaining CBC/diff. FUVB is an appropriate second source for BCX as it yields additional true pathogens. Our findings may support the presence of "culture-negative sepsis" in some neonates.

AB - Background: Minimizing initial neonatal blood draws and their associated pain is important. The placenta has ample fetal blood that is otherwise discarded; obtaining admission laboratory evaluations from fetal umbilical venous blood (FUVB) may provide a suitable alternative. Objective: We hypothesized that obtaining an aerobic bacterial blood culture (BCX) and a complete blood count with manual differential (CBC/diff) from FUVB is feasible and yields results comparable to those obtained directly from the neonate. Study Design: BCX and CBC/diff were attempted on paired samples from FUVB (in the delivery room) and neonatal blood (shortly after NICU admission) of 110 patients. The paired t test, Pearson's correlation coefficient (R), and multivariable linear regression were used for data analysis. Results: Positive BCXs were found in 9 of 108 FUVB samples compared to 1 of 91 neonatal samples. Three out of 9 FUVB cultures were true pathogens, including 2 Escherichia coli and 1 viridans group streptococcus, all with negative corresponding paired neonatal cultures. There was 1 positive neonatal BCX, E. coli, with a negative paired FUVB culture. Neonatal hemoglobin (Hb), platelets (PLT), and white blood cells (WBC) all significantly (p < 0.0001) correlated with the paired FUVB samples (R = 0.50, 0.49, and 0.84, respectively). Hb, PLT, and WBC values were clinically comparable but statistically higher in neonatal blood (the differences were 2.3 g/dL, 30,000 cells/μL, and 2,800 cells/μL, respectively; p < 0.007 for all comparisons). Conclusions: FUVB is suitable for obtaining CBC/diff. FUVB is an appropriate second source for BCX as it yields additional true pathogens. Our findings may support the presence of "culture-negative sepsis" in some neonates.

KW - Blood count

KW - Blood culture

KW - Cord blood

KW - Neonatal sepsis

KW - Umbilical venous blood

UR - http://www.scopus.com/inward/record.url?scp=85054783033&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85054783033&partnerID=8YFLogxK

U2 - 10.1159/000491993

DO - 10.1159/000491993

M3 - Article

VL - 115

SP - 49

EP - 58

JO - Neonatology

JF - Neonatology

SN - 1661-7800

IS - 1

ER -