Do Spinal Needle Sizes Affect the Development of Traumatic CSF in Neonatal LP Procedures?

Area of Science:

• Neonatal Medicine
• Pediatric Neurology
• Medical Device Technology

Background:

• Lumbar puncture (LP) is crucial for diagnosing neonatal diseases but has low success rates (45-54%).
• Limited research exists on how needle size impacts traumatic LP in newborns.

Purpose of the Study:

• To investigate the effect of different needle sizes on lumbar puncture traumatization in neonates.
• To compare traumatization rates and complications associated with 22-gauge versus 25-gauge needles.

Main Methods:

• Retrospective analysis of neonatal intensive care unit (NICU) patients who underwent lumbar puncture between November 2017 and July 2019.
• Lumbar puncture performed by specialists using either 22-gauge or 25-gauge pen-tip spinal needles.
• Evaluation of needle size's effect on LP traumatization, rates, and complications.

Main Results:

• A statistically significant difference was observed in traumatized LP rates between needle sizes (p=0.031).
• Significant differences were found in desaturation development (p=0.005) and CSF microscopic findings (p=0.006) related to needle size.
• 25-gauge pen-tip spinal needles resulted in less traumatic lumbar punctures in neonates compared to 22-gauge needles.

Conclusions:

• The choice of needle size significantly impacts the success and safety of lumbar puncture in neonates.
• Utilizing 25-gauge pen-tip spinal needles is recommended to minimize lumbar puncture trauma in the neonatal population.