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

Luca Bedetti, Licia Lugli, Lucia Marrozzini, Alessandro Baraldi, Federica Leone, Lorenza Baroni, Laura Lucaccioni, Cecilia Rossi, Maria F. Roversi, Roberto D'Amico, Lorenzo Iughetti, Alberto Berardi

Research output: Contribution to journalArticlepeer-review

Abstract

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 (SpO2 < 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 SpO2 desaturation or failure of LP. Results: Among 204 LPs, 134 were performed in full-term and 70 in pre-term born infants. SpO2 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 SpO2 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.

Original languageEnglish
Article number692652
JournalFrontiers in Pediatrics
Volume9
DOIs
Publication statusPublished - Jun 14 2021
Externally publishedYes

Keywords

  • lumbar puncture
  • meningitis
  • newborn
  • pre-maturity
  • sepsis
  • very low birth weight

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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