Safety and Success of Lumbar Puncture in Young Infants: A Prospective Observational Study

Frontiers in Pediatrics

article

Luca Bedetti¹  Roberto D'Amico³  Lorenzo Iughetti²  Alberto Berardi²  Licia Lugli²  Lucia Marrozzini⁴  Alessandro Baraldi⁴  Federica Leone⁴  Lorenza Baroni⁵  Laura Lucaccioni²  Cecilia Rossi²  Maria F. Roversi² 

[1] PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia;Neonatal Intensive Care Unit, Women's and Children's Health Department, University Hospital of Modena;Unit of Statistics, Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia;Pediatric Post-graduate School, University Hospital of Modena and Reggio Emilia;Neonatal Intensive Care Unit, Santa Maria Nuova Hospital

关键词: lumbar puncture;    meningitis;    sepsis;    newborn;    pre-maturity;    very low birth weight;   

DOI  :  10.3389/fped.2021.692652

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Objective: This study aims to evaluate safety and success rates of lumbar puncture (LP) and to identify factors associated with adverse events or failure of LP in infants. Methods: This two-center prospective observational study investigated infants younger than 90 days of age who underwent LP. Need for resuscitation oxygen desaturation (SpO 2 < 90%), bradycardia and intraventricular hemorrhage were considered adverse events. LP failed if cerebrospinal spinal fluid was not collected or had traces of blood. Logistic regression analysis was used to evaluate whether corrected gestational age (GA), body weight at LP, position, and any respiratory support during LP affected SpO 2 desaturation or failure of LP. Results: Among 204 LPs, 134 were performed in full-term and 70 in pre-term born infants. SpO 2 desaturations occurred during 45 (22.4%) LPs. At multivariate analysis, lower GA at LP ( p < 0.001), non-invasive respiratory support ( p 0.007) and mechanical ventilation ( p 0.004) were associated with SpO 2 desaturations. Transient, self-resolving bradycardia occurred in 7 (3.4%) infants. Two infants had intraventricular hemorrhage detected within 72 h of LP. No further adverse events were registered. Failure of LP occurred in 38.2% of cases and was not associated with any of the factors evaluated. Conclusions: LP was safe in most infants. Body weight or GA at LP did not affect LP failure. These data are useful to clinicians, providing information on the safety of the procedure.

【 授权许可】

CC BY