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当我们错过时会发生什么? 初始腰椎穿刺成功对婴儿败血症评估的影响
Amanda Dube1,2, Manaswitha Khare1,2, Michael Levy1,2
1Division of Pediatric Hospital Medicine, Rady Children's Hospital, San Diego, California.
Hospital pediatrics
|August 6, 2025
概括
在败血症评估期间未成功的婴儿腰部穿刺 (LPs) 与更长的住院时间有关. 重复LP,通常是由炎症标志物引起的,表明婴儿的医疗资源利用率更高.
科学领域:
- 儿科医学 儿科医学
- 新生儿科学 新生儿科学
- 传染性疾病 传染性疾病
背景情况:
- 腰部刺穿 (LPs) 对于婴儿败血症诊断至关重要,但初始失败率在12%至40%之间.
- 有限的研究存在于婴儿的特征和结果,成功与不成功的初始LP.
研究的目的:
- 描述接受败血症检查的婴儿的特征,管理和结果,成功与不成功的初始LPs.
- 分析那些经历了重复LP尝试的婴儿的结果.
主要方法:
- 在败血症评估期间接受LP的0-60天龄婴儿的回顾性横截面研究.
- 排除在ICU的婴儿,从其他医院转移,或复杂的医疗条件.
- 描述性统计和物流回归分析.
主要成果:
- 在468名婴儿中,82%的婴儿进行了成功的初始LP.
- 不成功的初始LP与更长的逗留时间 (LOS) (P=0.02) 有关.
- 患有成功LP的婴儿不太可能接受病毒检测,并且有较短的阿西克洛维尔疗程;重复LP与炎症标记的升高有关.
结论:
- 初始LP没有成功的婴儿经历了增加的LOS和资源使用.
- 重复LP,与炎症标志物升高有关,与更高的医疗利用相关.
- 需要进行进一步的前性或多中心研究,以制定指导方针,为婴儿不成功的LP治疗提供信息.
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