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

Abstract

Lumbar puncture (LP) is widely employed to evaluate infectious, neurological and metabolic diseases in the newborn. Neonatal LP is a difficult procedure with 45–54% success rates. Although there are studies examining traumatic LP failure, studies on the effects of needle sizes are limited. This study was intended to investigate the effect of needle sizes on LP traumatization. Term and premature babies who underwent LP in the neonatal intensive care unit between 30 November 2017 and 30 July 2019 were included in the study by retrospective file scanning. LP was performed by a pediatric or neonatal specialist using a 22 Gauge pen (G) or 25 G pen spinal needle in all cases, with all patients being placed in the lateral decubitus position. The primary outcome was to evaluate the effect of needle sizes used in LP on traumatization. The secondary outcome was to evaluate traumatization rates and complications. A statistically significant difference was determined in the rate of traumatized LP and desaturation development between needle sizes and CSF microscopic findings (p = 0.031, p = 0.005, and p = 0.006, respectively). The study data show that 25 G pen-tip spinal needles cause less traumatic LP in neonates than 22 G pen-tip spinal needles.

Special Issue: Advances in Healthcare for Neonates

“…In addition to ensuring the proceduralist′s technique, skills, and experience, it is also essential to use the correct size of needle when performing a procedure. In a study in this Special Issue, a smaller gauge (25G) lumbar puncture needle not only resulted in a decreased incidence of traumatic LP, but also a reduction in desaturation episodes during the procedure [ 6 ]. This study is a step in the right direction for providing neuroprotective care to these fragile infants.…”