Real-time ultrasound-guided lumbar puncture in the neonatal intensive care unit
Jason Z Stoller1, María Victoria Fraga2
1Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA. stoller@chop.edu.
Objective:
To determine the rates of traumatic lumbar puncture (LP) and overall success rates using the real-time ultrasound-guided technique when performed by a neonatal point-of-care ultrasound provider.
Study Design:
Retrospective observational study of 17 infants in the neonatal intensive care unit who underwent a real-time ultrasound-guided LP between March 2015 and November 2016. Spearman's correlation was calculated.
Results:
The first attempt and overall success rates were 65% and 100%, respectively. The rate of nontraumatic LP was 69%. CSF RBC count was inversely correlated with both PMA (Spearman's correlation coefficient (rs) = -0.74, p = 0.0017) and weight (rs = -0.74, p = 0.0015) at the time of LP.
Conclusions:
This study is the first to provide evidence of high success rates with real-time ultrasound-guided LP when performed by a neonatologist. Our data demonstrate feasibility in neonates over a broad range of weights, including premature infants as small as 750 g.
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