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Optimal position for a spinal tap in preterm infants.

C A Gleason, R J Martin, J V Anderson

    Pediatrics
    |January 1, 1983
    PubMed
    Summary
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    The flexed position for spinal taps in preterm infants significantly lowers oxygen levels more than extended or upright positions. Modifying the flexed position or using the upright position is recommended to reduce risks.

    Area of Science:

    • Neonatal Medicine
    • Pediatric Physiology
    • Medical Procedures

    Background:

    • Spinal taps in preterm infants can lead to clinical deterioration.
    • The optimal positioning for this procedure is crucial for infant safety.

    Purpose of the Study:

    • To investigate the optimal position for performing spinal taps in preterm infants.
    • To assess the physiological effects of different positions on preterm infants.

    Main Methods:

    • 17 healthy preterm infants were randomly assigned to three positions: lateral recumbent with full flexion, lateral recumbent with partial neck extension, and upright.
    • Transcutaneous oxygen (PO2) and carbon dioxide (PCO2) levels, minute ventilation, heart rate, and blood pressure were monitored.

    Main Results:

    Related Experiment Videos

    • Mean transcutaneous PO2 decreased in all positions, with a significantly greater decrease in the flexed position compared to extended and upright.
    • Transcutaneous PCO2 increased only in the flexed position.
    • No episodes of airway obstruction or apnea were observed.

    Conclusions:

    • The flexed position for spinal taps carries the greatest risk of potential morbidity due to greater decreases in PO2 and increases in PCO2.
    • Modifying the flexed position with neck extension or performing spinal taps in the upright position is recommended.