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Proportion of Successful Lumbar Punctures in Infants Younger Than Three Months
Rei Miyake1, Kento Ikegawa2, Hiroshi Hataya1
1Department of General Pediatrics, Tokyo Metropolitan Children's Medical Center, Tokyo, JPN.
Insights
Performing lumbar punctures (LPs) in infants under three months requires care to avoid traumatic taps. This study found 69% of LPs successfully obtained clear cerebrospinal fluid (CSF) without a traumatic tap, but identified no associated factors.
Area of Science:
- Pediatric Medicine
- Neurology
- Medical Procedures
Background:
- Lumbar punctures (LPs) in infants under three months carry risks of serious complications if traumatic taps occur.
- Previous studies reported the proportion of LPs yielding clear cerebrospinal fluid (CSF), but did not consistently exclude traumatic taps.
Purpose of the Study:
- To determine the proportion of successful LPs (clear CSF without traumatic tap) in infants younger than three months.
- To identify factors associated with successful LPs in this pediatric population.
Main Methods:
- Retrospective, observational study of infants (<3 months) undergoing LP in a pediatric emergency department (April 2018 - March 2021).
- Primary outcome: proportion of successful LPs defined as obtaining clear CSF without any traumatic tap.
- Multiple logistic regression analysis was used to identify factors associated with successful LPs.
Main Results:
- 121 infants were included in the analysis.
- A successful LP was achieved in 83 infants (69%).
- No specific factors were found to be significantly associated with successful LPs.
Conclusions:
- The study established a benchmark success rate of 69% for LPs yielding clear CSF without traumatic taps in young infants.
- Larger studies utilizing precise definitions of successful LPs are necessary to identify factors that can improve success rates in this vulnerable age group.
Abstract:
It is important to perform lumbar punctures (LPs) without a single traumatic tap in infants younger than three months owing to the risk of serious complications. The proportion of LPs in which clear cerebrospinal fluid (CSF) was obtained has been previously reported, but some of the procedures involved a traumatic tap. The present study aimed to identify the proportion of LPs in which clear CSF was obtained without a single traumatic tap and the factors associated with successful LPs in infants younger than three months. This retrospective, observational study included children younger than three months who underwent an LP in the pediatric emergency department between April 2018 and March 2021. The primary outcome was the proportion of successful LPs, defined as LPs obtaining clear CSF without a single traumatic tap. Multiple logistic regression analysis was used to identify factors related to successful LPs. Of 126 eligible patients, 121 were included. Among these, 83 (69%) were in the successful group. No factors significantly associated with successful LPs were found. Larger studies based on an accurate definition of successful LPs, such as that provided by this study, are needed to investigate related factors to increase the rate of successful LPs in this age group.
