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The parenteral route is a critical method of drug administration. It delivers compounds directly into the systemic circulation and bypasses the gastrointestinal tract. This approach is particularly advantageous for drugs that exhibit poor absorption or instability when administered orally.
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Updated: Apr 21, 2026

A Modified Method for Intrathecal Catheterization in Rats
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A Hospitalist-Run Procedure Service Safely Streamlines Inpatient Intrathecal Chemotherapy.

Ghadi Ghanem1, Allyson Malone1, Lillian Chen2

  • 1Department of Medicine, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, USA.

Cureus
|April 20, 2026
PubMed
Summary
This summary is machine-generated.

A hospitalist-led medical procedure service (MPS) provides faster intrathecal chemotherapy administration for oncology patients with thrombocytopenia, reducing delays and traumatic taps compared to radiology-guided lumbar punctures.

Keywords:
hospitalist medicineintrathecal chemotherapyintrathecal infusionlength of staylumbar puncture (lp)medical proceduremedical proceduresprocedure servicethrombocytopeniatransfusion threshold

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Area of Science:

  • Oncology
  • Hematology
  • Neurosurgery

Background:

  • Intrathecal chemotherapy via lumbar puncture (LP) is crucial for CNS spread in hematologic malignancies.
  • Refractory thrombocytopenia often delays LP and increases platelet transfusion use.
  • Current practices involve radiology-guided LP with strict platelet counts or hospitalist-led medical procedure service (MPS) with individualized thresholds.

Purpose of the Study:

  • To compare outcomes and complications of intrathecal chemotherapy administration by radiologist-guided fluoroscopy versus bedside MPS.
  • To evaluate the efficiency and safety of MPS in managing thrombocytopenic oncology patients.

Main Methods:

  • Retrospective cohort study of adult inpatients receiving intrathecal chemotherapy from August 2019 to May 2022.
  • Data extracted from electronic medical records, including demographics, labs, and procedure timing.
  • Major complications assessed via imaging review; traumatic taps evaluated by CSF RBC count.

Main Results:

  • 564 procedures analyzed: 485 by radiology, 79 by MPS.
  • MPS performed LPs at significantly lower platelet thresholds (49% < 50,000 vs. 6.4%, p < 0.001).
  • MPS showed faster turnaround (6 vs. 24 hours, OR: 0.41, p<0.001) and fewer traumatic taps (71% decrease, OR = 0.29, p = 0.002) with low complication rates (MPS 1.3% vs. Radiology 1.6%).

Conclusions:

  • Hospitalist-run MPS expedites care for thrombocytopenic oncology patients with low complication rates.
  • MPS offers a viable alternative to radiology for intrathecal chemotherapy, particularly in patients with low platelets.
  • Further research needed on MPS impact on length of stay and cost savings.